Remote IDR Compliance Specialist in Healthcare

Capitol Bridge, Llc; Virginia; Hybride; USD 70 000 - 85 000; Plein temps

Résumé du poste

Capitol Bridge, LLC is seeking an IDR Compliance Specialist to support the federal IDRE program, ensuring eligibility determinations, arbitration decisions, and case handling meet CMS guidance and internal standards.

The role emphasizes detail orientation, regulatory interpretation, and collaboration with legal, operations, and quality teams to drive compliant processes and training materials.

Qualifications

• Bachelor’s degree required; JD or compliance certification preferred.
• 2+ years of experience in healthcare compliance, regulatory affairs, legal operations, or related settings.
• Familiarity with No Surprises Act and federal IDR process preferred.
• Strong attention to detail and ability to interpret regulatory guidance.

Responsabilités

• Conduct compliance reviews of eligibility determinations, arbitration decisions, and case files for regulatory alignment.
• Apply policies to IDR work and escalate complex questions to the Senior Manager, IDR Compliance.
• Assist in drafting and maintaining policies, procedures, and desk guides translating regulatory requirements into operations.
• Document issues, support root cause analysis, and track corrective actions through completion.
• Track compliance data and prepare reports for leadership; support audits and CMS oversight activities.

Connaissances

Compliance

Regulatory affairs

Healthcare

Formation

Bachelor’s degree

Juris Doctor (JD) or compliance certification

Outils

Microsoft Excel

Case management systems

Description du poste

Capitol Bridge, LLC is seeking an IDR Compliance Specialist to support the federal IDRE program, ensuring eligibility determinations, arbitration decisions, and case handling meet CMS guidance and internal standards.

The role emphasizes detail orientation, regulatory interpretation, and collaboration with legal, operations, and quality teams to drive compliant processes and training materials.