Claims Review Dermatologist

Capitol Bridge; Washington (District of Columbia); On-site; USD 100,000 - 150,000; Full time

Job summary

A leading company in medical reviews is seeking a Claims Review Dermatologist. This role involves resolving disputes and conducting thorough reviews of medical documentation. Candidates must have extensive clinical experience and a valid medical license. Join a team committed to high standards and effective communication.

Qualifications

• At least five years of full-time clinical care experience within the past three years.
• Non-restricted license in any US state.

Responsibilities

• Conduct impartial assessments of documentation from all parties.
• Review medical documentation to determine necessity or appropriateness of services.

Skills

Clinical Care

Communication

Task Management

Education

Medical License

Certification by American Medical Specialty Board

Tools

Microsoft Office

Job description

Join to apply for the Claims Review Dermatologist role at Capitol Bridge

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

Capitol Bridge is seeking an experienced 1099 Claims Review Dermatologist. This role involves resolving claim disputes submitted by healthcare providers and assisting both contracted and non-contracted providers and plans. The position requires conducting reviews efficiently, promptly, and professionally.

Salary Range: Approximately $250 per case, depending on case requirements.

Key Responsibilities:

1. Conduct impartial assessments of documentation from all parties.
2. Review medical documentation to determine the necessity or appropriateness of services/procedures.
3. Use governmental and professional guidelines to support determinations.
4. Adhere to policies, regulations, and project guidelines.
5. Maintain effective communication and ensure timely review completion.
6. Follow QA/QC processes and meet standards.
7. Uphold scheduling commitments and privacy regulations.
8. Perform other duties as directed by leadership.

Required Qualifications:

1. Licensed in the required specialty.
2. At least five years of full-time clinical care experience within the past three years.
3. Non-restricted license in any US state; for physicians, current certification by a recognized American medical specialty board.

Preferred Qualifications:

1. Familiarity with claims and review processes.
2. Experience navigating electronic documents and using Microsoft Office tools.
3. Ability to manage sensitive information and communicate effectively.
4. Ability to work independently and prioritize tasks.

Additional Information:

Employment is contingent upon passing a background check. Reasonable accommodations are available for applicants with disabilities. Capitol Bridge is an Equal Opportunity Employer and communicates via text, email, and phone with applicants.