Medical Analyst

Job Description

We are seeking Medical Analysts with experience in reviewing medical treatment related to injury claims. This includes experience in medical reviews or utilization reviews, preparing chronologies, analyzing treatment in medical claims and medical bill reviews. Experience in reviews on behalf of insurance carriers or defense counsel is a plus. 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 chronologies and provide an analysis of treatment/medical bills for appropriateness under medical guidelines and standards.

• 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: Rehabilitation Counseling, Disability Management, Utilization Review, Life Care Planning, Medical Coding, Legal Nurse Consulting a plus
• MSCC Certification a plus
• 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

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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.