Remote Healthcare Claims Review Attorney

Capitol Bridge, Llc; Sector Toledo (PR); Remoto; USD 70.000 - 80.000; Tempo pieno

Descrizione del lavoro

Capitol Bridge Puerto Rico seeks an experienced Healthcare Claims Review Attorney to support dispute resolution for Florida CDR and multi-state IRO programs. The role provides legal analysis, guides reviewers, and ensures determinations align with statutes, rules, and contracts.

The attorney collaborates with RN reviewers, coding specialists, clinicians, and leadership to translate regulatory changes into reviewer guidance and operational controls.

Competenze

• J.D. from an accredited law school required.
• Strong research and writing abilities.
• Ability to interpret statutes, regs, contracts and program guidance.

Mansioni

• Review complex healthcare claim disputes for legal and regulatory issues.
• Provide legal guidance to reviewers and program leadership while preserving clinical independence.
• Interpret governing authorities and draft defensible determinations and communications.

Conoscenze

Legal research

Regulatory interpretation

Analytical writing

Communication skills

Stakeholder collaboration

Formazione

Juris Doctor (J.D.) from an accredited law school

Descrizione del lavoro

Capitol Bridge Puerto Rico seeks an experienced Healthcare Claims Review Attorney to support dispute resolution for Florida CDR and multi-state IRO programs. The role provides legal analysis, guides reviewers, and ensures determinations align with statutes, rules, and contracts.

The attorney collaborates with RN reviewers, coding specialists, clinicians, and leadership to translate regulatory changes into reviewer guidance and operational controls.