Legal Nurse Reviewer

Company Description


ISO Claims Partners, a Verisk business, is a nationally recognized leader in providing cost-effective and proven Medicare compliance and claim analytics services for Workers’ Compensation, First-Party No-Fault, and Liability claims. For the past two decades we have been a trusted consultant and provider to the largest carriers, TPAs, and self-insured Fortune 1000 companies in the world. We draw on unique data assets and deep domain expertise to develop products and services designed with one goal in mind: improving claims outcomes throughout the life of a claim. We accomplish this by providing cutting-edge analytics, unmatched data, and superior medical and legal advocacy – with big payoffs, taking claims organizations from a reactive to a proactive approach. ISO Claims Partners is headquartered in North Reading, Massachusetts, and has offices throughout North America. To learn more about ISO Claims Partners, please visit us at www.verisk.com/claimspartners. We are proud to be a part of the Verisk family of companies!

At the heart of what we do is help clients manage risk. Verisk (Nasdaq: VRSK) provides data and insights to our customers in insurance, energy and the financial services markets so they can make faster and more informed decisions.

Our global team uses AI, machine learning, automation, and other emerging technologies to collect and analyze billions of records. We provide advanced decision-support to prevent credit, lending, and cyber risks. In addition, we monitor and advise companies on complex global matters such as climate change, catastrophes, and geopolitical issues.

But why we do our work is what sets us apart. It stems from a commitment to making the world better, safer and stronger.

It’s the reason Verisk is part of the UN Global Compact sustainability initiative. It’s why we made a commitment to balancing 100 percent of our carbon emissions. It’s the aim of our “returnship” program for experienced professionals rejoining the workforce after time away. And, it’s what drives our annual Innovation Day, where we identify our next first-to-market innovations to solve our customers’ problems.

At its core, Verisk uses data to minimize risk and maximize value. But far bigger, is why we do what we do.

At Verisk you can build an exciting career with meaningful work; create positive and lasting impact on business; and find the support, coaching, and training you need to advance your career. We have received the Great Place to Work® Certification for the fifth consecutive year. We’ve been recognized by Forbes as a World’s Best Employer and a Best Employer for Women, testaments to our culture of engagement and the value we place on an inclusive and diverse workforce. Verisk’s Statement on Racial Equity and Diversity supports our commitment to these values and affecting positive and lasting change in the communities where we live and work.


Job Description


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.

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 (
Company
ISO
Posted
11/22/2021
Salary Range
$67,000.00 - 100,000.00
per Year
Salary range estimated by
Location
North Reading, MA 01864, US
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