RN - Medical Allocator I
11 days ago
West Des Moines
Job Description The Medical Allocator creates a cost projection of a patient’s medical treatment needs by reviewing medical records and identifying a pattern of care. The medical cost projection, also knowns as a Medicare Set-Aside (MSA) report, is part of a workers’ compensation or liability claim settlement. The Medical Allocator will rely on their medical knowledge and guidelines provided by the Centers for Medicare and Medicaid Services (CMS) to evaluate the patient’s treatment plan for future medical treatment needs. Work from home possible. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Collaboration with the claim adjuster, • Review medical records to prepare a Medicare Set-Aside allocation (MSA) report, • Perform evidenced based medical research, • Utilize medical knowledge to outline the patient’s medical treatment., • Assign pricing to medical treatment allocations, • Assign pricing to medication allocations, • Prepare submission of MSA report to CMS for review and approval, • Secure, review, and dispute Medicare conditional payments unrelated to claim/s in settlement process, • Required to read extensively., • Required to prepare organized reports within a specified timeframe., • Required to use computer extensively., • Requires regular and consistent attendance., • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)., • Additional duties as required. KNOWLEDGE & SKILLS: • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment., • Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers., • Excellent written and verbal communication skills., • Ability to meet designated deadlines., • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets., • Strong interpersonal, time management and organizational skills., • Ability to work both independently and within a team environment. EDUCATION & EXPERIENCE: • Graduate of accredited school of nursing, BSN desirable., • Current RN Licensure in state of operation., • 3 or more years’ of recent clinical experience, preferably in rehabilitation., • Certification as a MSCC, CLCP, or CNLCP preferred., • ICHCC approved course in Medicare Set-Aside completion within 3 months of hire date required., • Successfully pass ICHCC Medicare Set-Aside Consultant examination within 4 months of hire date., • Strong clinical background in orthopedics, neurology, or rehabilitation preferred., • Strong cost containment background, such as utilization review or managed care helpful. PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 – $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
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