Medical Consultant

This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources.

Principal Duties and Responsibilities

Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions
Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis
Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis
Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience
Perform telephone contacts with the insured’s healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities
Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices
Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency
Focus not only on individual workload, but on the team/group work volumes to ensure organizational success
Receive feedback and follow through with appropriate behaviors/actions
Perform other duties as assigned