Job description
We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications. Candidates will demonstrate knowledge of CMS policies related to preparing MSAs. Strong writing skills, analysis skills and application of guidelines are required for this position. Medical Analysts will work closely with our attorneys and other members of the medical team to prepare Medicare Set-Asides and Medical Cost Projections.
Responsibilities
- Through a review of relevant medical files and related documentation, provides a narrative and cost projection for future treatment related to Workers Compensation and Liability injuries consistent with the current guidelines
Collaborates with a team of attorneys and medical professionals in identifying negotiating and documenting guidelines and cost reductions on future treatment plans
Uses ISO Claims Partners proprietary information technology tools to identify diagnoses, treatment guidelines, and prescription medication pricing, and documents the case when applicable
Provides additional analysis and medical recommendations as needed
Identifies cost drivers and cost savings opportunities on all files and completes client specific -cost mitigation activities on files where applicable
This is a full-time position, but additional hours may be required during peak time
Occasional travel
Requirements
- Bachelor’s Degree, Associate Degree or Diploma in Nursing required
3-5 years’ experience in Nursing preferred
Registered Nurse (RN) license in good standing with applicable Board of Nursing required
Experience in preparing medical review reports, medical bill reviews and utilization reviews in injury cases preferred
Certification in any of the following preferred: Medicare Set-aside Certified Consultant (MSCC), Life Care Planner (CLCP or CNLCP), Certified Case Manager (CCM), Medical Coding, Legal Nurse Consulting, Rehabilitation Counseling, Disability Management, Utilization Review
Strong interpersonal, oral, and written communication skills including report preparation preferred
Ability to work effectively both independently and as a member of a team
Ability to gather data, compile and synthesize information, including medical information, claims payment histories and billing, to identify level and types of services utilization
About Verisk
For over 50 years, Verisk has been the leading data analytics and technology partner to the global insurance industry by delivering value to our clients through expertise and scale. We empower communities and businesses to make better decisions on risk, faster.
At Verisk, you'll have the chance to use your voice and build a rewarding career that's as unique as you are, with work flexibility and the support, coaching, and training you need to succeed.
For the eighth consecutive year, Verisk is proudly recognized as a Great Place to Work® for outstanding workplace culture in the US, the fourth consecutive year in the UK, Spain, and India, and the second consecutive year in Poland. In addition, we’ve been recognized by The Wall Street Journal as one of the Best-Managed Companies and by Forbes as a World’s Best Employer, testaments to the value we place on workplace culture.
We’re 7,000 people strong. We relentlessly and ethically pursue innovation. And we are looking for people like you to help us translate big data into big ideas. Join us and create an exceptional experience for yourself and a better tomorrow for future generations.
