Medical Analyst (UR.MPCR)

  • Full-time
  • Verisk Business: Casualty Solutions (ISOCP)

Company Description

ISO, a Verisk business, has been a leading source of information about property/casualty insurance risk since 1971. For a broad spectrum of commercial and personal lines of insurance, ISO provides statistical, actuarial, underwriting, and claims information and analytics; compliance and fraud identification tools; policy language; information about specific locations; and technical services. ISO serves insurers, reinsurers, agents and brokers, insurance regulators, risk managers, and other participants in the property/casualty insurance marketplace. To learn more about ISO please visit us at:  www.verisk.com/iso. We are proud to be a part of the Verisk family of companies!

With a history of impressive growth, an innovative culture, and offering industry-leading solutions, Verisk Analytics is an amazing place to work and make a difference. In 2018, Forbes magazine named Verisk to its World’s Best Employers list and, in 2017, to its World’s Most Innovative Companies list for the third consecutive year. We also earned the Great Place to Work® Certification for the third consecutive year in recognition of our outstanding workplace culture.

Verisk is a leading data analytics provider serving customers in insurance, energy and specialized markets, and financial services. Using advanced technologies to collect and analyze billions of records, Verisk draws on unique data assets and deep domain expertise to provide first-to-market innovations integrated into customer workflows. We’ve been delivering predictive analytics and decision support solutions to our customers for nearly 50 years, helping them protect people, property, and financial assets. At Verisk, you’ll be part of an organization that’s committed to serving the long-term interests of our stakeholders, including the communities where we operate.

At Verisk, you can build an exciting career with meaningful work; create a positive and lasting impact on the business; and find the support, coaching, and training you need to advance your career. Our culture of innovation means your ideas on how to improve our business will be heard. As key contributors to our success, our team members enjoy working in a business-casual, collaborative environment that offers state-of-the-art resources, advanced technologies, and an excellent benefits package.

Job Description

Our ISO Claims Partners business in North Reading, MA is 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 (<10% of the time)
 

Qualifications

About You and How You Can Excel in This Role
•    Bachelor’s Degree
•    3-5 years’ experience
•    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: Rehabilitation Counseling, Disability Management, Utilization Review, Life Care Planning, Medical Coding, Legal Nurse Consulting and 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
 

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Additional Information

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

http://www.verisk.com/careers.html

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