Capitol Bridge, LLC.

The attorney will evaluate Workers' Compensation Medicare Set-aside Arrangement (WCMSA) proposals to project future medical costs in accordance with CMS guidelines. They will also review medical records to ensure proposals meet Medicare threshold requirements and adequately consider beneficiary needs.

The Operations Administrator supports Independent Review Organization (IRO) case management by coordinating documentation, maintaining tracking systems, and managing secure file sharing. They also oversee clinical reviewer coordination, final determination distribution, and invoice processing while ensuring compliance with regulatory requirements.

Resolve claim disputes submitted by healthcare providers, hospitals, and pharmacies. Provide professional assistance to health care plans and providers to reach claim resolutions.

Evaluate Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) proposals to project future medical costs in accordance with CMS guidelines. Review medical records to ensure proposals meet Medicare threshold requirements and protect Medicare's interests.