Rising Medical Solutions
Lead Legal Nurse
Job Description
Bring your expertise to the Rising team to assist with the expansion of our new demand package product!
The Lead Legal Nurse plays a critical role in evaluating the medical necessity, appropriateness, and cost of medical services within auto, general liability, and workers’ compensation claims while leading the direction and the program. This role combines clinical expertise with analytical review to support claim adjudication, demand package evaluation, and dispute resolution.
The ideal candidate has some leadership experience or is looking to step up, along with experience reviewing plaintiff demand packages, assessing medical records for causation, necessity, and reasonableness, cost, and supporting defensible positions in negotiation, litigation, or audit environments. and is successfully able to:
+ Evaluate liability demand packages, including medical records, billing, and treatment timelines to identify gaps, inconsistencies, and cost drivers
+...
The Lead Legal Nurse plays a critical role in evaluating the medical necessity, appropriateness, and cost of medical services within auto, general liability, and workers’ compensation claims while leading the direction and the program. This role combines clinical expertise with analytical review to support claim adjudication, demand package evaluation, and dispute resolution.
The ideal candidate has some leadership experience or is looking to step up, along with experience reviewing plaintiff demand packages, assessing medical records for causation, necessity, and reasonableness, cost, and supporting defensible positions in negotiation, litigation, or audit environments. and is successfully able to:
+ Evaluate liability demand packages, including medical records, billing, and treatment timelines to identify gaps, inconsistencies, and cost drivers
+...