IDR Compliance & Policy Analyst

Capitol Bridge, LLC.; Virginia; On-site; USD 70,000 - 95,000; Full time

Job summary

Capitol Bridge is seeking an IDR Compliance Specialist to support the No Surprises Act compliance program. You will review eligibility determinations, arbitration decisions, and case files to ensure alignment with statute, regulation, CMS guidance, and internal standards.

You will apply established policies, draft and maintain procedures, and collaborate across teams to communicate guidance. A JD or compliance cert plus 2+ years in healthcare compliance is preferred.

Qualifications

• Bachelor’s degree required; JD, paralegal certificate, or compliance cert preferred.
• 2+ years of experience in healthcare compliance or regulated settings.
• Ability to read, interpret, and apply regulatory guidance to real cases.
• Proficiency with case management systems and Microsoft Office, especially Excel.

Responsibilities

• Conduct compliance reviews of eligibility determinations, arbitration decisions, and case files.
• Apply policies to day-to-day IDR work and escalate complex questions to management.
• Draft and maintain policies, procedures, and job aids translating regulatory requirements.
• Document issues, collect info for root-cause analysis, and track corrective actions.
• Monitor CMS guidance and regulatory updates; summarize changes for leadership.
• Assist with audits and CMS oversight activities, gathering documentation.

Skills

Attention to detail

Communication

Regulatory interpretation

Project management

Education

Bachelor's degree

Juris Doctor (JD)

Paralegal certificate

CCEP

CHC

Tools

Microsoft Office

Excel

Case management systems

Job description

Capitol Bridge is seeking an IDR Compliance Specialist to support the No Surprises Act compliance program. You will review eligibility determinations, arbitration decisions, and case files to ensure alignment with statute, regulation, CMS guidance, and internal standards.

You will apply established policies, draft and maintain procedures, and collaborate across teams to communicate guidance. A JD or compliance cert plus 2+ years in healthcare compliance is preferred.