Clinical Specialist LPN/RN, Disability Claims

As the Clinical Specialist LPN/RN, Disability Claims you will perform necessary outreaches to claimants or treating providers to obtain certification dates, treatment plans and any other pertinent medical information necessary to facilitate and assist claims managers in adjudicating disability claims decision. They will leverage their medical knowledge to determine what medical information is needed and perform the necessary steps needed to obtain this information. This individual may also be required to help with coordinating and overseeing vendor utilization and assist in determining overall function as needed in order to facilitate timely claim decisions. You are Knowledgeable in a variety of medical and behavioral health conditions Vendor management: Works collaboratively with vendors to schedule and follow up for vendor reports Excellent written and verbal communication skills Ability to exercise independent & sound judgment in decision making Excellent time management & organizational skills Multitasking with the ability to manage continually changing priorities and ability to prioritize work based on customer service needs and departmental regulations. Self-motivated & able to work independently. Ability to work collaboratively with multiple professional disciplines and with diverse populations. Current medical knowledge of medical conditions and treatment is maintained via continuing education You will Review information in file, obtain medical information needed and/or acquire certification of disability and limitations from treating physicians Assist with Vendor Management Document clear and concise details regarding certification dates, treatment plans as well as other pertinent claim information identified. Collaborate with the Claims Case Manager and the Claimant to facilitate timely physician outreaches and collection of medical information Remain flexible to changing business needs and assist the team where needed in order to meet the needs of our customers You have LPN / LVN from an accredited school of Nursing with a valid license in good standing Minimum 2 years of clinical experience or equivalent medical office experience Basic computer skills & knowledge, including Microsoft office and One Note Continuously strives to provide superior products and customer service Expresses oneself in an open and honest manner Demonstrates self-awareness and embraces feedback Location & Vaccination Requirements Flexible – work primarily from home. May be expected to come into a Guardian work location occasionally, as determined by their people leader. Salary Range: $57,810.00 - $86,715.00 The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation. Our Promise At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. Inspire Well-Being As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits. Equal Employment Opportunity Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law. Accommodations Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected]. Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday. Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being — mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com. Apply tot his job