Claims Processor - February Start Date

Principle Choice Solutions LLCDecatur, GA
3d$17Remote

About The Position

This position will complete distribution or processing (review and determine payment of claims) for FMP, Spina Bifada, CHAMPVA, Beneficiary Travel and Non-VA Medical Care claims for the VA. This includes processing claims from the Aged Claims inventory and any current claims as requested by the VA CBO and will utilize the VA systems for claims adjudication. Training will be provided on all VA claims systems.

Requirements

  • High School Diploma or GED required.
  • Candidates must provide two valid forms of identification, one of which must be either a REAL ID (indicated by a star in the top corner) or a valid U.S. passport.
  • Demonstrated negotiation skills.
  • General office skills and knowledge of standard office equipment.
  • Working knowledge of software such as Excel and Word.
  • Data entry and 10 key experience necessary.
  • Excellent verbal and written communication skills
  • Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, personal honesty and integrity, and a demonstration of placing others in a place of high value.

Nice To Haves

  • Preferred 1-2 years' experience in medical claims, patient accounting, comprehension of insurance contracts and/or EOBs, and other medical billing methodologies or demonstrated ability.

Responsibilities

  • Research and evaluate accounts for proper adjudication.
  • Perform electronic claims editing and submit claims validation for payment processing.
  • The systems used, include but are not limited to, the ClaimsXM system, Datanet, and the Daper system.
  • Utilize VA's contracts to evaluate accuracy of payment.
  • Document claims processing activity into VA systems.
  • Maintain a working knowledge of applicable VA regulations as they relate to proper claims adjudication.
  • Maintain access for all client systems, as assigned.
  • Meet/Exceed monthly productivity and accuracy standards.
  • Acts as an effective team member.
  • Other duties as assigned.
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