MSA Nurse Reviewer

Posted on Sep 27, 2024 by Claims Solutions
Woburn, MA
Health Care
Immediate Start
Annual Salary
Full-Time
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)

Reference: 202577316

https://jobs.careeraddict.com/post/95610352

MSA Nurse Reviewer

Posted on Sep 27, 2024 by Claims Solutions

Woburn, MA
Health Care
Immediate Start
Annual Salary
Full-Time
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)

Reference: 202577316

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