Legal Nurse Reviewer

Verisk Analytics • Woburn, MA

9h • Remote

About The Position

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. Responsibilities About the Day to Day Responsibilities of the Role Through a review of relevant medical files and related documentation, provides a chronology, analysis and medical bill review and cost projection for injuries cases consistent with the current guidelines Collaborates with a team of attorneys and medical professionals in identifying mitigating issues for injury claims Uses ISO Claims Partners proprietary information technology tools to identify diagnoses and treatment guidelines when applicable Provides additional professional analysis and recommendations as needed This is a full-time position, but additional hours may be required during peak time Occasional travel (<10% of the time) Qualifications About You and How You Can Excel in This Role Bachelor’s Degree, Associate Degree or Diploma in Nursing 3-5 years’ experience in Nursing RN license in good standing with the applicable Board of Nursing Experience in preparing medical review reports, medical bill reviews and utilization reviews in injury cases Certification in any of the following, including but not limited to: Legal Nurse Consulting, Rehabilitation Counseling, Disability Management, Utilization Review, Life Care Planning, Medical Coding, Case Management 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

Requirements

• Bachelor’s Degree, Associate Degree or Diploma in Nursing
• 3-5 years’ experience in Nursing
• RN license in good standing with the applicable Board of Nursing
• Experience in preparing medical review reports, medical bill reviews and utilization reviews in injury cases
• 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

Nice To Haves

• Experience in reviews on behalf of insurance carriers or defense counsel is a plus
• Certification in any of the following, including but not limited to: Legal Nurse Consulting, Rehabilitation Counseling, Disability Management, Utilization Review, Life Care Planning, Medical Coding, Case Management a plus

Responsibilities

• Through a review of relevant medical files and related documentation, provides a chronology, analysis and medical bill review and cost projection for injuries cases consistent with the current guidelines
• Collaborates with a team of attorneys and medical professionals in identifying mitigating issues for injury claims
• Uses ISO Claims Partners proprietary information technology tools to identify diagnoses and treatment guidelines when applicable
• Provides additional professional analysis and recommendations as needed

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees