Join to apply for the Claims Review Pulmonologist role at Capitol Bridge.
About Capitol Bridge
Founded in 2012, Capitol Bridge is based in Arlington, Virginia, with expertise in independent medical reviews, records/data management, medical coding, administrative staffing, and eligibility reviews.
Capitol Bridge is seeking an experienced 1099 Claims Review Pulmonologist. The role involves resolving claim disputes submitted by healthcare providers and assisting in the fair and efficient resolution of these disputes. Responsibilities include conducting impartial assessments, reviewing medical documentation, and ensuring compliance with guidelines and regulations.
Salary Range: Approximately $250 per case, depending on case requirements.
Key Responsibilities:
- Conduct impartial assessments of documentation from all parties involved.
- Review medical documentation to determine the necessity or appropriateness of services/procedures.
- Utilize guidelines to support determinations.
- Adhere to policies, regulations, and project guidelines.
- Maintain effective communication and timely review completion.
- Follow QA/QC processes and uphold privacy standards.
- Perform other duties as assigned.
Required Qualifications:
- Licensed in the required specialty.
- Five years of full-time clinical care experience.
- Recent clinical care experience within the past three years.
- Non-restricted medical license in any US state; board certification in relevant specialty for physicians.
Preferred Qualifications:
- Familiarity with claims and review processes.
- Experience with electronic documents and Microsoft Office.
- Strong organizational, communication, and confidentiality skills.
- Ability to work independently and prioritize tasks.
Additional Information:
- Background check required.
- Employment is contingent upon passing the background check.
- Reasonable accommodations available upon request.
- Capitol Bridge is an Equal Opportunity Employer.