Prepares and drafts Medical Cost Projects (MCP), and Medicare Set-Asides and other related products.
Reviews medical claims and legal records
Provides concise written reports depicting past medical care, current medical status, and anticipated future medical care
Creates reports documenting comprehensive and detailed medical summaries, evaluation of past treatment procedures, and prediction and accurate pricing of future treatment plans.
Provides consulting services for assigned claims examiner and defense/plaintiff counsel related to medical issues.
Creates and implements custom solutions to Medical-related problems including formulating solutions and communicating effectively verbally and in writing with healthcare provides, claims examiners, and counsel to implement solutions.
Identifies and resolves issues related to pricing MCPs (Medical Cost Projections) and Medicare Set-Asides or other products.
Ensures quality, medical soundness, accuracy, and timely delivery of MCPs and MSA’s.
Provides changes/updates to the Medical Cost Projection or MSA as needed.
Maintains appropriate file documentation.
Maintains comprehensive knowledge of pricing trends for Medical Cost Projections and Medicare Set-Aside reports.
Maintains thorough knowledge of Medical Treatment Guidelines
Has the following credentials RN, or life care planner with a minimum of 5-years-experience in either workers compensation and or Liability claims. Experience in both would be a big plus.