Job Overview
We are actively seeking dedicated Medical Analysts with expertise in the preparation of Medicare Set-Asides (MSAs) and Medical Cost Projections. This remote position involves meticulous review of medical records, crafting detailed narratives, and making informed decisions regarding allocations for medical treatments and necessary prescription medications. Candidates must have a robust understanding of CMS policies associated with MSAs. Exceptional writing and analytical capabilities, along with a sharp ability to interpret guidelines, are critical for success in this role. As a Medical Analyst, you will collaborate closely with our legal team and medical professionals to ensure precise and effective medical cost projections.
Key Responsibilities
- Perform comprehensive reviews of pertinent medical documentation to generate in-depth narratives and financial projections for future medical treatments associated with Workers’ Compensation and Liability cases, guaranteeing compliance with current guidelines.
- Collaborate with a team of attorneys and healthcare experts to negotiate, document, and identify guidelines and possible cost-saving measures for future treatment plans.
- Leverage proprietary technology tools to ascertain diagnoses, treatment protocols, and pricing for prescription medications, ensuring accurate documentation of findings.
- Provide additional analytical insights and medical recommendations as required, lending your expertise to enhance team efficacy.
- Recognize cost drivers and opportunities for savings across various cases, executing client-specific cost mitigation strategies where appropriate.
Qualifications
- A Bachelor's Degree, Associate Degree, or Diploma in Nursing is mandatory.
- 3-5 years of nursing experience is preferred.
- A valid Registered Nurse (RN) license in good standing with the appropriate Board of Nursing is essential.
- Prior experience in preparing medical review reports, medical bill assessments, and utilization reviews in injury-related cases is preferred.
- Relevant certifications such as Medicare Set-Aside Certified Consultant (MSCC), Life Care Planner (CLCP or CNLCP), Certified Case Manager (CCM), or others are advantageous.
Required Skills
- Strong communication skills, both verbal and written, especially in report preparation.
- Ability to work efficiently both independently and as part of a collaborative team.
- Proficient in collecting, compiling, and synthesizing medical data and claims payment histories to discern service utilization patterns.
Career Growth Opportunities
Join us and discover a culture that prioritizes learning, compassion, and outcomes, with a steadfast dedication to inclusivity and diversity. You will have the chance to advance your career in an environment that values your contributions and fosters professional development.
Company Culture And Values
We foster a collaborative and supportive work culture that emphasizes the importance of inclusivity and the diverse perspectives of our team members. You will be part of a reputable organization committed to making a meaningful impact in the healthcare landscape.
Employment Type: Full-Time