DI Benefits Medical Cons
Core
Provide technical medical expertise and support to Benefit Claims analysts by reviewing claims, evaluating provider medical records, and consulting on disability claim assessments.
Role type
Senior Disability Benefits Medical Consultant
Builds
Disability insurance claim assessments and medical reviews
Domain
Insurance / Disability Benefits
Required skills
Critical care nursing, Medical-surgical nursing, Orthopedic nursing, Physician's assistant, Nurse practitioner, Complex claims assessment, Medical case consultation, Dispute resolution, Coaching & mentoring, Adaptive communication
Preferred skills
Orthopedic medicine, Physical medicine and rehabilitation, Disability insurance knowledge
Technologies
Windows environment
Responsibilities
Review claims and evaluate provider medical records and test results; Consult with analysts and medical directors on claim assessments and treatment appropriateness; Coordinate medical referrals and ensure thorough reviews; Train new disability benefits analysts and consultants; Participate in interdepartmental projects and peer auditing; Resolve claim medical disputes via negotiation or litigation.
Seniority
Senior, hands-on IC