MEDICOLEGAL ANALYST (LAW DEPT) Lv2
About The Position
Medicolegal Analysts in the Workers’ Compensation Division are responsible for all medically related issues for medical management of workers’ compensation claims. Responsibilities include: Consult managerial and legal staff in regards to medical necessity of treatment as it relates to injured workers’ injured sites. The review and prior approval of medications for claimant’s work related injuries done telephonically, email and through the New York State Workers’ Compensation mandated prior authorization medication portal. The portal is time sensitive and requires prompt review and response. Any review not made timely may result in an order from the State to dispense medication that may be not related to the claimant’s job related injury. Assist examiner and legal staff to determine compensability of treatment as it relates to the claimant’s work injury and assist with medical case management of claims. Review and process high value and complicated in-patient billing. Coordinate with hospital administrators and social workers with the discharge of workers’ compensation patients and aggressively negotiate rates for sub-acute and/or home care. Review independent medical examinations to ensure quality control of reports and verify medical examiners panels for proper credentials. New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview. To Apply Click "APPLY" MEDICOLEGAL ANALYST (LAW DEPT) - 06591
Requirements
- A valid license as a New York State Registered Professional Nurse and 2 years of satisfactory nursing experience in a hospital environment; or
- A valid New York State registration as a Physicians' Assistant and 1 year of satisfactory experience as a physician's assistant in a hospital environment.
- For assignment to the Worker's Compensation Division candidates will be required, in addition to meeting the minimum requirements, to possess an ICD9CM coding certificate or one year of equivalent experience.
Responsibilities
- Consult managerial and legal staff in regards to medical necessity of treatment as it relates to injured workers’ injured sites.
- Review and prior approval of medications for claimant’s work related injuries done telephonically, email and through the New York State Workers’ Compensation mandated prior authorization medication portal.
- Assist examiner and legal staff to determine compensability of treatment as it relates to the claimant’s work injury and assist with medical case management of claims.
- Review and process high value and complicated in-patient billing.
- Coordinate with hospital administrators and social workers with the discharge of workers’ compensation patients and aggressively negotiate rates for sub-acute and/or home care.
- Review independent medical examinations to ensure quality control of reports and verify medical examiners panels for proper credentials.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
Number of Employees
101-250 employees
