As a Behavioral Health Consultant, you will provide consultation services to maximize return-to-work outcomes and duration of claims by providing understanding of medical documentation. Develop analysts and team members by sharing medical knowledge. Independently provide behavioral health consultative services to claims staff with information and tools to assist with claim decisions including clearly noting what rationale is/was used to determine suggested direction. Make appropriate decisions when to leverage external resources (IME, Peer review) and develop questions to include as necessary. Contact claimant or Attending Physician when appropriate for interview regarding condition, symptoms, functionality, treatment plan and clarification of restrictions if needed. Impact claims facilitation with internal and external customers by providing accurate, concise and timely written and verbal communications. Maintain a high level of knowledge of behavioral health conditions and recovery periods to consistently and effectively coach and develop staff. Maximize team performance by development of claims staff by sharing knowledge as well as sharing information learned from CEU seminars. General knowledge of STD and LTD policy provisions to ensure appropriate direction of consultative services. Perform other job-related duties and special projects as required.
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Job Type
Full-time
Career Level
Mid Level