Job Details

ID #19752064
State North Carolina
City Northreading
Job type Full-time
Salary USD TBD TBD
Source Verisk
Showed 2021-09-17
Date 2021-09-16
Deadline 2021-11-15
Category Et cetera
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Medical Analyst

North Carolina, Northreading 00000 Northreading USA

Vacancy expired!

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.

About the Day to Day Responsibilities of the Role

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 (<10% of the time)

Qualifications

  • Bachelor’s Degree
  • 3-5 years’ experience
  • RN license in good standing with the applicable Board of Nursing
  • Experience in preparing Medicare Set Asides and future cost projections
  • Certification in any of the following, including but not limited to Medicare Set-Aside Certified Consultant (MSCC), Life Care Planning (CLCP or CNLCP), Certified Case Manager (CCM), Rehabilitation Counseling, Disability Management, Utilization Review, Medical Coding, Legal Nurse Consulting

Additional Information

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

http://www.verisk.com/careers.html

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

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