Mitchell International, Inc. 3rd Party Medical Reviewer - Part Time in San Diego, California
Mitchell, Genex and Coventry
With Mitchell, Genex and Coventry now one organization, we’ve dramatically expanded our ability to deliver innovative services and technologies to our customers. We’ve also seen career opportunities within our combined organization grow. Each part of our organization helps people recover after a challenging event in their lives.
Mitchell delivers trusted software and services to the property & casualty claims, collision repair and risk management industries with technology-enabled solutions that simplify claims handling, repair processes and pharmacy transactions. Genex helps injured workers return to their jobs in a safe and efficient manner through compassionate case management, reducing health care costs and disability expenses for our customers. Coventry offers the nation’s largest and most diverse set of provider and ancillary networks focused on improving total overall outcomes.
Together, we bring a complete set of proven capabilities for our partners who require more than one-dimensional solutions. We combine innovative technology, insightful analytics and deep expertise to help them reach their ultimate goal—restoring lives.
The Medical Claims Consultant utilizes his/her clinical skill set to review medical records and bills, specifically comprehension of the method of injury. A correlation between injury and med records takes place and recommendations are relayed to the claims adjuster for assistance in claim negotiations. The Consultant utilizes clinical experiences, evidenced based guidelines, clinical resources/research and clinical judgement to help determine casualty and relatedness.
Knowledge: You are a seasoned, experienced professional with a full understanding of auto casualty and general liability. You will work one case at a time with approximately 23-30 cases a month. A clinical background related to trauma, orthopedic, physical and rehabilitation nursing is required.
Experience: Mitchell’s Medical Claims Consultants are Registered Nurses and will typically have at least 3 years clinical experience and one year within auto casualty. Legal nurse consulting is preferred.
Written Abilities: Proficient grammar, sentence structure and written communication skills required.
Licenses or Certifications: You must be a registered nurse (RN). Having certifications within Legal Nurse Consulting and CPC are a plus.
Fluent with computers and software applications
Ability to meet deadlines
Mitchell International, an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. Mitchell will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.
Req ID: 20-10844
External Company URL: http://www.mitchell.com
Street: 6220 Greenwich Drive
Remote position: Yes