Appeals Specialist
PATRIOTCLAIMS LLC• US,
•$70,000 - $75,000•Remote
About The Position
The Appeals Specialist serves as the primary advocate and case manager for veterans navigating the VA appeals process. This role owns each case from intake through resolution, ensuring accuracy, compliance, and a high-quality veteran experience at every stage. This position is critical to VetClaims.ai’s mission—transforming a complex and frustrating system into a structured, supportive, and successful journey for the veterans we serve.
Requirements
- Strong organizational and case management skills
- Excellent written and verbal communication abilities
- Ability to manage multiple cases in a deadline-driven environment
- Comfortable working remotely across time zones
- Experience with VA claims or appeals processes
- Working Knowledge Of: Supplemental Claims, Higher-Level Review, and BVA
- Working Knowledge Of: 38 CFR and VA rating principles
- Working Knowledge Of: M21-1 Adjudication Manual
- Experience with CRM systems, Google Workspace, Slack, and Zoom
Nice To Haves
- Compliance-driven or regulated environments
Responsibilities
- Manage a full caseload of VA appeals from intake through final resolution
- Serve as the veteran’s dedicated point of contact throughout the process
- Track deadlines, milestones, and required actions to ensure timely case progression
- Maintain accurate, audit-ready documentation within CRM and internal systems
- Review VA decisions, service records, and medical evidence to identify gaps and opportunities
- Coordinate supporting documentation (nexus letters, buddy statements, lay evidence)
- Ensure all submissions meet VA standards for accuracy, completeness, and relevance
- Guide veterans through each stage of the appeals process with clear next steps
- Counsel veterans on appeal options and recommend the most strategic path forward
- Identify evidentiary gaps and advise on required documentation
- Prepare veterans for exams, hearings, and VA interactions
- Provide proactive updates and timely responses to veteran inquiries
- Handle sensitive topics with professionalism, empathy, and discretion
- Document all communications clearly and consistently
- Partner with C&P Prep, Fulfillment, and other departments to support case success
- Escalate complex cases, compliance risks, or legal concerns appropriately
- Contribute insights on VA trends, denial patterns, and process improvements
- Follow all VetClaims.ai SOPs, workflows, and documentation standards
- Maintain strict confidentiality of veteran data (PII/PHI)
- Participate in QA reviews, coaching, and continuous improvement initiatives
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
