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Nurse Reviewer (LPN/RN) Disability Claims
Location: Fully Remote (U.S. Only)
Pay Rate: $27.50/hour (W2)
Contract Duration: September through February (with potential extension)

About the Role

Are you a licensed nurse with a passion for clinical assessment and disability case management? Join our clientsDisability team as a Nurse Reviewer, where youll leverage your clinical expertise to evaluate disability claims, support return-to-work strategies, and collaborate with claim specialists, healthcare providers, employers, and claimants.

In this role, youll play a critical part in ensuring fair, evidence-based disability determinations while helping individuals navigate their recovery and return to productive employment.

Responsibilities

• Conduct comprehensive clinical reviews for Short-Term Disability (STD), Long-Term Disability (LTD), and Family & Medical Leave (FML) claims.
• Evaluate medical records, treatment plans, and physician documentation to determine functional abilities and disability status.
• Compare clinical findings against disability guidelines to identify functional limitations and residual work capacity.
• Develop and recommend individualized, goal-focused Return-to-Work (RTW) plans.
• Communicate with claimants, physicians, employers, and internal partners to obtain clinical clarification and facilitate timely claim decisions.
• Identify medical, social, psychological, vocational, and workplace barriers impacting return-to-work outcomes.
• Provide clinical consultation and education to Disability Claim Specialists regarding medical conditions, treatment plans, and disability assessments.
• Collaborate with cross-functional teams to ensure consistent application of disability policies and best practices.
• Support continuous improvement initiatives and participate in special projects as assigned.
• Maintain compliance with company policies, confidentiality standards, regulatory requirements, and ethical guidelines.
• Serve as a clinical resource while embodying MetLifes values and commitment to customer care.

Minimum Qualifications

• Current LPN or RN license that is active and in good standing throughout the duration of the assignment.
• Minimum 3 years of clinical nursing experience working with adult patient populations.
• Associate degree in Nursing required.
• Strong understanding of medical terminology, clinical documentation, and patient care practices.
• Excellent analytical, critical thinking, and clinical decision-making skills.
• Strong verbal and written communication skills.
• Ability to manage multiple priorities while meeting deadlines.
• Comfortable working independently in a fully remote environment while collaborating across teams.
• Proficiency using multiple systems, applications, and technology platforms.

Preferred Qualifications

• Bachelors degree in Nursing (BSN).
• Experience in one or more of the following:
  • Disability insurance
  • Workers Compensation
  • Case Management
  • Occupational Health
  • Rehabilitation Medicine
  • Private Rehabilitation
  • Risk Management
  • Home Health
• Knowledge of disability duration guidelines.
• Experience interpreting medical documentation for disability determination.
• Familiarity with CPT and ICD coding.
• Experience developing Return-to-Work programs and managing disability cases.

What Makes You Successful

Were looking for professionals who are:

• Detail-oriented with exceptional clinical judgment.
• Skilled at interpreting complex medical information.
• Comfortable communicating with physicians, employers, and claimants.
• Organized and able to manage competing priorities.
• Collaborative, empathetic, and customer-focused.
• Confident making evidence-based recommendations.
• Passionate about helping individuals safely return to work.