Sunrise, FL, US
11 days ago
Clinical Advocate
Welcome page Returning Candidate? Log back in! Clinical Advocate Posted Date 15 hours ago(11/7/2024 2:45 PM) Requisition ID 2024-26512 Job Locations US-FL-Sunrise Position Type Regular Full-Time Category Medical Case Management Business Unit BUS_TPA US Excellence In Everything We Touch

Position Summary

The Clinical Advocate provides medical and vocational assistance to claimants that are unable to work, or have physical or psychological impairments that limit their ability to perform essential job duties. The Clinical Advocate will review medical documentation, and work closely with the claim team and internal clinical resources in making recommendations that address functionality and focus on a healthy return to work. The Clinical Advocate will have contact with the claimant and employer in facilitating any temporary or permanent job modifications necessary for a return to work within the applicable restrictions given by the treating provider as needed. The Clinical Advocate will support the claimant’s participation in various programs, activities and services designed to help them with a return to previous levels of functioning.

Responsibilities Reviews claim documentation and reports, collects and analyzes medical data, assesses client's leave and disability statusEvaluates claimant’s functionality based on medical information received and reviews job description when considering return to work plansDemonstrates ability to meet or surpass administrative requirements, including productivity, time management, quality assessment (QA) standards with a minimum of supervisory interventionEstablishes a professional working relationship with the claimant, treating provider, client representatives and the claim team members. Coordinates return to work plans with the claim team and parties aboveMay recommend and facilitate additional services, peer reviews, IME’s, ergonomic and vocational assessments as neededProvides analysis of restrictions and limitations submitted and makes recommendations to facilitate rehabilitation goals and RTW. Strong focus given to modified RTW to help transition claimant back to full dutyMaintains contact and communicates with claims teams to apprise them of case activity, or to receive authorization for additional servicesReviews cases with immediate supervisor and claim team monthly to evaluate file and obtain directionResponsible for documentation in claims system with focus on clinical assessment, RTW goals, scheduling follow up contacts, and providing guidance to the claim teamLimited travel may be neededMay perform other related duties as assignedUpholds the Crawford Code of Conduct Requirements Bachelor’s degree in a health-related field is required. Bachelor’s degree in Nursing preferred.For Vocational Clinical Advocates, a master’s degree in vocational counseling, or rehabilitation counseling is preferred.For a Nursing Clinical Advocates, a valid RN license is required. Individuals must hold an active, registered nurse professional license without restrictions to practice as a health professional in a state or territory of the United States.Minimum 3-4 years full time clinical experience as it relates to leave and disability claims administration.Limited travel may be neededDemonstrated ability to handle complex assignments and ability to work independently is required.Effective oral and written communication skills are required.Thorough understanding of leave and disability matters and advanced knowledge about workplace restrictions and modifications.Ability to exert positive influence in all areas of RTW negotiation and coordinationAdvanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned.Highly skilled at promoting leave and disability products and services internally and externally. About Us Why Crawford?

 

Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time.

 

At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.

 

We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.

 

When you accept a job with Crawford, you become a part of the One Crawford family. 

 

Our total compensation plans provide each of our employees with far more than just a great salaryPay and incentive plans that recognize performance excellenceBenefit programs that empower financial, physical, and mental wellnessTraining programs that promote continuous learning and career progression while enhancing job performanceSustainability programs that give back to the communities in which we live and workA culture of respect, collaboration, entrepreneurial spirit and inclusion

 

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

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