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VA Data Entry/Appeals Representative

Signature Performance

Signature Performance


Job title:
VA Data Entry/Appeals Representative

Job level:

Job description:
Job Description

Primary Responsibilities:

Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers.

? Extensive work experience within own function.

? Work is frequently completed without established procedures.

? Works independently.

? May act as a resource for others.

? May coordinate others\\\\\\\' activities.

Required Qualifications:

? High School Diploma / GED (or higher).

? 2 + years of healthcare claims benefits experience including researching claim denials.

? 2 + years of experience in a customer service environment.

? 1+ years Claims Appeal experience.

? 1+ years Creating Business Letters

? Basic Proficiency in Microsoft Excel and Word (ability to create, edit, save, and send).

Preferred Qualifications:

? Knowledge of TRICARE or Medicare (CMS) Policy and Processes.

Soft Skills:

? Ability to ask probing questions to identify underlying issues.

? Ability to think analytically.

? Time management and organizational skills.

? Issue resolution skills as well as the ability to interact with internal and external customers.

Positions available:

Posted on:
May 4, 2021