[Remote] Attorney/Case Reviewer II - Remote (57368)

Note: The job is a remote job and is open to candidates in USA. Capitol Bridge, founded in 2012 and based in Arlington, Virginia, specializes in independent medical reviews and related services. They are seeking an Attorney / Case Reviewer II to evaluate Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) proposals and project future medical costs related to workers’ compensation injuries.

Responsibilities

• Review and evaluate workers’ compensation Medicare set-aside (WCMSA) proposals, including medical records, to determine if the proposal meets Medicare threshold requirements and adequately considers Medicare’s interests as pertaining to future medical needs of beneficiaries
• Ensure all basic documentation requirements are available or requested via development action prior to making a determination
• Render determinations based on professional experience
• Implement Medicare policy
• Other duties as assigned by management

Skills

• Bachelor's degree in Nursing (BSN) or a higher-level medical degree from an accredited college or university, and/or a Juris Doctor (JD) from an accredited law school, required
• At least 1 year of Medicare Set-Aside (MSA) or related experience, required
• Medical record review experience, required
• Possess medical knowledge and experience with medical terminology, ICD-9/10 Codes, Current Procedure Terminology Codes (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes, and hospital inpatient and outpatient coding, preferred
• Medicare Set-Aside Certified Consultant (MSCC) certification and/or Certified Medicare Secondary Payer (CMSP) certification, preferred

Benefits

• Medical, Dental, and Vision benefits available
• 401(k) available with company match
• Paid holidays
• Unlimited PTO

Company Overview