Claims Review Psychiatrist

Capitol Bridge; United States; Remote; USD 200,000 - 250,000; Full time

Job summary

Capitol Bridge, a leading healthcare company, is seeking a Claims Review Psychiatrist to resolve claim disputes efficiently. The role involves reviewing medical documentation and ensuring compliance with guidelines. Ideal candidates will have extensive clinical experience and strong communication skills.

Qualifications

• Licensed in the required specialty.
• At least five years of full-time clinical care experience.

Responsibilities

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

Skills

Communication

Organizational Skills

Teamwork

Education

Board Certification in Relevant Specialty

Tools

Microsoft Office

Job description

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 Psychiatrist. This role is crucial for the fair and efficient resolution of claim disputes.

You will be responsible for resolving claim disputes submitted by physicians, hospitals, institutions, pharmacies, and other healthcare providers. You will also assist contracted and non-contracted healthcare providers and plans in dispute resolution. The role requires efficiency, professionalism, and courtesy in all duties.

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

Key Responsibilities:

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

Required Qualifications:

• Licensed in the required specialty.
• At least five years of full-time clinical care experience.
• Experience providing clinical care within the past three years.
• Non-restricted license in any US state and board certification in relevant specialty areas.

Preferred Qualifications:

• Familiarity with claims and review processes.
• Experience navigating electronic documents and Microsoft Office tools.
• Ability to manage sensitive information.
• Strong organizational, communication, and teamwork skills.
• Ability to prioritize tasks effectively.

Additional Information:

Screenings: Background check required; employment contingent upon successful completion.

Reasonable Accommodation: Contact employer directly for alternative application or screening methods.

EEO Statement: Capitol Bridge LLC is an Equal Opportunity Employer, making employment decisions regardless of protected statuses.

Texting Notice: We may contact applicants via text; opt-out options available.