Arbiter (State Specific Attorney) 250519 (Remote)

About Capitol Bridge
Founded in 2012, Capitol Bridge is based in Arlington, Virginia and has proven expertise providing independent medical reviews, records/data management services, medical coding, administrative staffing and eligibility reviews.

Capitol Bridge Inc is seeking a highly skilled and detail-oriented Arbiterto join our team. The Arbiter will be responsible for arbitrating/deciding payment disputes, analyzing documentation, and managing case files. The ideal candidate has a strong understanding of Microsoft systems, excellent writing skills, and a keen eye for detail.

Location: Remote (preferred location in CST or EST areas)

Pay and Benefits:
Base Rate: $70,000 to $90,000 depending on qualifications.
Medical, Dental, and Vision benefits available
401(k) available with company match
Paid holidays
Paid Vacation Time

Job Responsibilities:

-This role is primarily responsible for arbitrating/deciding payment disputes
- The arbiter must remain neutral when analyzing the materials provided, and must be able to write a concise determination in a short period of time to meet deadlines
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case
- Research issues using federal law, federal regulations, relevant contract law Review plan contracts and other relevant information; make a decision as to whether an enrollee is entitled to benefits in cases involving contractual disputes
- Communicate the determination in a clearly written format
- Exercise independent judgment to ensure determination is accurate, well supported and defensible; take appropriate action as required
- Acquire all necessary information involving cases and render final determination based on the information provided by the appellant
- Manage highly complex case files
- Perform other duties as may be assigned by management
- Draft and review payment determination decisions
- Draft email responses to payment dispute questions or concerns from the disputing parties
- Interpret applicable regulations and policies associated with case to determine recommendation
- Ensure solutions are consistent with organizational objectives

Qualifications & Experience:
- Juris Doctorate preferred
- 3+ years of relevant professional experience required
- Minimum of 3+ years of arbitrating or adjudicating and processing disputes in medical field
- Ability to perform comfortably in a fast-paced, deadline-orientated work environment
- Excellent organizational, interpersonal, written, and communication skills
- Ability to work as a team member, as well as independently
- Work across multiple systems, such as SharePoint, Salesforce, and Microsoft Office products

Reasonable Accommodation
If you require alternative methods of application or screening, you must approach the employer directly to request this. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

EEO Statement
Capitol Bridge, Inc. is an Equal Opportunity Employer. All employment decisions at Capitol Bridge are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

Texting Notice
We communicate with applicants by text in addition to email and phone. If you apply for this position, we may text you about this position, your application for the position, or other things relevant to this job position. If we text you and you no longer want us to text you, you can opt-out at that time.