Claims Associate

2 weeks ago

Conroe, United States Gumps Victor Alpha Compensation Services Full time

**Claims Associate**

**Classification**: Non-Exempt

**Schedule**: 40-hour workweek

**Location**: On-site

**Reports to**: Claims Agent

***

**ESSENTIAL DUTIES AND RESPONSIBILITIES**
- Process mail and gather all private medical records (not yet received by VA). Facilitate medical research and opinions to support issues.

Directly handle all VA claims submittals.

Collect completed forms from the client.
- Assist the client with completing simple routine VA Forms assigned by the VA Claims Agent or Case Manager under the direction of the VA Claims Agent.
- Identify new possible issues based upon review of medical records and research to refer to advocate.
- Request claims folders from VA. o Handle any necessary follow up with client for return of signed forms.
- **While not primarily responsible for phone calls, serve as a backup to Case Manager to answer questions and concerns.**
- Review medical records received from medical facility or from clients. Outline medical records along with treatment dates in Prevail’s history.
- Process incoming mail:

- Summarize all Rating Decisions, BVA Decisions, Statement of Case, Supplemental Statement of Case to include issues in question, specifically listing findings of facts, reason for decision, and determining elements missing for favorable decision (when applicable) per request of VA.
- Review and summarize any VA development letter.
- Collaborate daily with case managers.
- Perform other duties as assigned.
- **This job description is intended to convey information essential to understanding the scope of the job and the general nature and level of work performed by job holders within this job. It is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position. **_

**KNOWLEDGE, SKILLS, AND ABILITIES**
- **Attention to detail** is required.
- Must have office experience, be extremely organized, be compassionate
- Ability to work independently and with various staff members
- Strong oral and written communication skills are required
- Ability to handle a fast-paced environment, and meet deadlines
- Strong customer service skills and the ability to prioritize
- Basic understanding of VA rules and regulations as it pertains to compensation cases is required.
- Working knowledge of Prevail system is a plus
- Proficient in MS Office (Word, Excel)

**EDUCATION AND EXPERIENCE**
- High School diploma or GED is required. Some college courses are preferred.
- At least one year of experience as Intake Specialist or related field is required.
- Experience in the medical field working with medical records is a plus.
- Experience working on VA cases is a plus.
- Experience with extensive client telephone contact; drafting correspondence and researching decisions

Pay: From $18.00 per hour

Expected hours: 40 per week

**Benefits**:

- Flexible schedule
- Flexible spending account

Schedule:

- 8 hour shift

Work setting:

- In-person

**Experience**:

- Microsoft Office: 1 year (preferred)
- Customer service: 1 year (preferred)

Ability to Commute:

- Conroe, TX 77304 (required)

Ability to Relocate:

- Conroe, TX 77304: Relocate with an employer provided relocation package (required)

Work Location: In person

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