MSA Nurse Reviewer

Job Description We are seeking a MSA Nurse Reviewer with experience in preparing Medicare Set Asides and Medical Cost Projections. Candidates will demonstrate knowledge of CMS policies related to preparing MSAs, strong writing and analysis skills, and ability to apply guidelines. Medical Analysts will work closely with attorneys and other members of the medical team to prepare Medicare Set-Asides and Medical Cost Projections. Responsibilities Through a review of relevant medical files and related documentation, provide a narrative and cost projection for future treatment related to Workers Compensation and Liability injuries consistent with current guidelines. Collaborate with a team of attorneys and medical professionals in identifying negotiating and documenting guidelines and cost reductions on future treatment plans. Use ISO Claims Partners proprietary IT tools to identify diagnoses, treatment guidelines, and prescription medication pricing, and document the case where applicable. Provide additional analysis and medical recommendations as needed. Identify cost drivers and cost savings opportunities on all files and complete client‑specific cost mitigation activities on files where applicable. This is a full‑time position; additional hours may be required during peak time. Occasional travel may be required. Qualifications Bachelor’s Degree, Associate Degree or Diploma in Nursing required. 3‑5 years’ experience in nursing preferred. Registered Nurse (RN) license in good standing with applicable Board of Nursing required. Experience in preparing medical review reports, medical bill reviews and utilization reviews in injury cases preferred. Certification in any of the following preferred: Medicare Set‑aside Certified Consultant (MSCC), Life Care Planner (CLCP or CNLCP), Certified Case Manager (CCM), Medical Coding, Legal Nurse Consulting, Rehabilitation Counseling, Disability Management, Utilization Review. 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 levels and types of services utilization. Benefits Verisk invests in a benefits package for all employees that includes health insurance, a retirement plan, disability benefits, and a paid time off program. We offer a competitive total rewards package that includes a base salary determined based on role, experience, skill set, and location. Equal Employment Opportunity Statement 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. Verisk’s minimum hiring age is 18 except in countries with a higher age limit subject to applicable law. #J-18808-Ljbffr