Disability Clinical Reviewer

Responsibilities:

• Review referred medical claims to determine whether documentation supports disability or work‑related restrictions.
• Assess the impact of medical conditions on an individual’s ability to perform essential job duties.
• Evaluate functional limitations and recommend reasonable accommodations when appropriate.
• Serve as a clinical resource for the leave of absence team, offering guidance on medical conditions, restrictions, and return‑to‑work planning.
• Act as the primary clinical contact for workers’ compensation inquiries related to medical progress and work status.
• Communicate professionally with team members, healthcare providers, and internal partners by phone or in writing to discuss clinical status, progress, and work capabilities.
• Provide clear explanations of clinical determinations and ensure all stakeholders understand next steps.
• Document all clinical decisions, rationale, and supporting information accurately in Absence Soft.
• Maintain compliance with internal policies, confidentiality standards, and regulatory requirements.

Education/Experience

• Active clinical credential (RN, NP, PA, or similar healthcare background) required
• Strong understanding of functional capacity, disability guidelines, and workplace accommodations.
• Experience in disability management, leave administration, or workers’ compensation preferred.
• Excellent written and verbal communication skills.
• Ability to analyze medical information and apply sound clinical judgment.