Certified Professional Coder

Capitol Bridge is actively searching for a Certified Professional Coder who not only meets our high standards but exceeds them. This crucial role, available for remote work or on-site in Isabella, PR, is at the heart of our operations, contributing significantly to the Florida Statewide Health Plan Claim Dispute Resolution Program. This program, governed by the Agency for Health Care Administration, is dedicated to ensuring equitable and efficient resolutions to claim disputes.

The successful candidate will analyze claim disputes from various healthcare entities, including physicians, hospitals, pharmacies, and other licensed providers. You will also handle disputes involving Health Maintenance Organizations (HMOs), Primary Health Care centers (PHCs), Exclusive Provider Organizations (EPOs), Prepaid Health Plans (PHPs), major medical insurance policies, and Preferred Provider Organizations (PPOs). This role demands a commitment to efficiency, timeliness, productivity, consistency, courtesy, and professionalism.

Why Capitol Bridge?

Founded in 2012, with our headquarters in Arlington, Virginia, and a strategic branch in Isabella, Puerto Rico, we're a thriving SBA 8(a) Certified Small Disadvantaged Business. Our expertise spans independent medical reviews, records/data management, medical coding, administrative staffing, and eligibility reviews. Joining us means becoming part of a team renowned for its commitment to excellence and innovation.

Salary Range: $18 - $22 hourly, commensurate with experience

Your Role and Responsibilities:

• Perform unbiased evaluations of medical documentation from all parties involved in disputes.
• Assess the validity of claims processed across various health plans and markets.
• Identify and report any discrepancies or deficiencies in dispute submissions.
• Ensure compliance with all relevant company policies, state regulations, and project guidelines.
• Maintain open and effective communication through regular meetings.
• Complete dispute evaluations promptly to meet deadlines.
• Adhere to stringent QA/QC protocols to uphold company and departmental standards.
• Participate in ongoing training and team meetings to stay abreast of policies and procedures.
• Commit to scheduled hours while respecting privacy and confidentiality requirements.
• Take on additional training and perform other duties as assigned by leadership.

Required Skills and Experience:

• Mandatory Certified Professional Coder (CPC) certification.
• Associate degree is required; Bachelor's Degree is preferred.
• At least 3 years of experience in medical coding, with a focus on claims dispute evaluations.
• Proven ability to handle sensitive information with the utmost discretion.
• Exceptional organizational skills, along with proficient written and verbal communication abilities in English.
• Capability to work independently and as part of a team.
• Demonstrated skill in prioritizing tasks in line with company objectives and deadlines.

Reasonable Accommodation Notice

Capitol Bridge is dedicated to complying with both federal and state laws regarding disabilities, ensuring reasonable accommodations for applicants and employees with disabilities. Should you require accommodations to engage in the application or interview process, perform essential job functions, or access other benefits and privileges of employment, please reach out to our recruiting team for assistance.

Equal Employment Opportunity (EEO) Statement

Capitol Bridge is committed to fostering a diverse and inclusive workplace as an Equal Opportunity Employer. Our employment decisions are made strictly based on business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV status, sexual orientation, gender identity and/or expression, marital status, civil union or domestic partnership status, past or current military service, family medical history or genetic information, family or parental status, or any other protected category under applicable laws and regulations.

Text Communication Consent

At Capitol Bridge, we utilize various methods to communicate with applicants, including text messaging, email, and phone calls. By applying for this position, you acknowledge that you may receive text messages related to your application, the position, or other relevant job-related information. If at any point you wish to stop receiving text