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Medical Analyst (Remote)

ISO

Medical Analyst (Remote)

Boston, MA +3 locations
Full Time
Paid
  • Responsibilities

    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 records and related documentation, creates a narrative and develops a cost projection for future treatment related to Workers’ Compensation and Liability injuries consistent with current guidelines
    • Collaborates with a team of attorneys and other medical professionals in identifying, negotiating, and documenting guidelines and performing cost mitigation on future treatment plans
    • Uses ISO Claims Partners proprietary technology tools to identify diagnoses, treatment guidelines, and prescription medication pricing
    • Provides additional analysis and medical recommendations as needed
    • This is a full-time position on a remote work basis, but additional hours may be required during peak time
    • Occasional travel (<10% of the time)
  • Qualifications

    Qualifications

    • Bachelor’s Degree, Associate’s Degree or Diploma in Nursing
    • Registered Nurse (RN) license required in good standing with the applicable Board of Nursing
    • Experience preferred in preparing Medicare Set Asides and future cost projections
    • Certification in any of the following preferred, 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 
    • Strong interpersonal, oral, and written communication skills
    • 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

    #LI-JE1

    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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  • Locations
    Tampa, FL • Lafayette, LA • Boston, MA • Cleveland, OH