Role Overview:

We are seeking licensed PHRN or USRN professionals with Clinical Disability Claims experience to join US. You will conduct clinical case reviews, assess disability claims, and ensure accurate and timely determinations for Short-Term and Long-Term Disability cases.

Key Responsibilities:

• Conduct clinical case reviews for disability claims.

• Assess Short-Term and Long-Term Disability cases.

• Review medical records and clinical documentation.

• Determine claim eligibility based on clinical guidelines.

• Collaborate with physicians and healthcare providers.

• Document clinical findings and claim determinations accurately.

• Ensure compliance with insurance regulations and standards.

Qualifications:

• Active PHRN or USRN license – required.

• 3 years Hospital bedside experience (handled intensive care) – required.

• Minimum 2 years in Clinical Disability Claims (Short-Term/Long-Term Disability preferred) – required.

• Experience in private or commercial insurance – required.

• Must have experience in Clinical Case Review – required.

• Strong clinical assessment and analytical skills.

• Detail-oriented with excellent documentation skills.

• Amenable to Work From Home setup with shifting schedules.

Why Join?

• Competitive salary package (A2 and B1 levels).

• 100% Work From Home – nationwide.

• Career growth in clinical disability claims.