Job Description
Overview:
We are excited to welcome Medical Analysts who have experience in preparing Medicare Set-Asides (MSAs) and Medical Cost Projections. This role involves reviewing medical records, preparing comprehensive narratives, and determining appropriate allocations for medical treatment and prescription medications. Candidates should possess a solid understanding of CMS policies related to MSAs. Strong writing and analytical skills, as well as a keen ability to apply guidelines, are essential for success in this position. As a Medical Analyst, you will collaborate closely with our attorneys and the broader medical team to ensure accurate and effective medical cost projections.
Key Responsibilities:
Conduct thorough reviews of relevant medical files and documentation to provide detailed narratives and cost projections for future treatments related to Workers' Compensation and Liability injuries, ensuring alignment with current guidelines.
Work collaboratively with a team of attorneys and medical professionals to identify, negotiate, and document guidelines and potential cost reductions for future treatment plans.
Utilize proprietary information technology tools to identify diagnoses, treatment guidelines, and prescription medication pricing, documenting the findings as necessary.
Offer additional analysis and medical recommendations as needed, contributing your expertise to the team.
Identify cost drivers and potential savings opportunities across all cases and complete client-specific cost mitigation activities where applicable.
This is a full-time position; additional hours may be required during peak periods.
Occasional travel may be required (less than 10% of the time).
Qualifications:
About You:
A Bachelor's Degree, Associate Degree, or Diploma in Nursing is required.
3-5 years of experience in Nursing is preferred.
A valid Registered Nurse (RN) license in good standing with the applicable Board of Nursing is essential.
Experience in preparing medical review reports, medical bill reviews, and utilization reviews in injury cases is preferred.
Certification in any of the following is a plus: 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, or Utilization Review.
Strong interpersonal, oral, and written communication skills are essential, particularly in report preparation.
Ability to work effectively both independently and collaboratively as part of a team.
Proficient in gathering, compiling, and synthesizing data, including medical information and claims payment histories, to identify levels and types of service utilization.
Why Join Us?
We value a culture of learning, caring, and results, with a strong commitment to inclusivity and diversity. You will have the opportunity to grow your career in a supportive environment where your contributions are valued. Join us in making meaningful impacts through your work and help us create a better tomorrow.
Employment Type: Full-Time
Salary: $ 23.00 Per Hour
Job Tags
Hourly pay, Full time,