Claim Manager Clinician (Remote)

Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

What's in Store
We are on the lookout for a Claim Manager Clinician to join our team. The Claim Manager Clinician (CMC) is a Registered Professional Nurse or Licensed Social Worker responsible for managing a daily caseload of Long Term Care (LTC) Claims in a fast-paced, remote office environment. Using established claim policies and guidelines, the CMC evaluates claims to determine whether the Insured is benefit qualified and receiving covered services from an eligible provider. The CMC also educates policyholders on their coverage and communicates directly with service providers and physicians to facilitate claim resolution.