VA (Veterans Affairs) Claims Analyst Position Available In Manatee, Florida
Tallo's Job Summary: VA Claims Analyst at Transcend Health Solutions, LLC in Bradenton, Florida. Responsibilities include reviewing, submitting, and monitoring medical claims to Veterans Affairs, analyzing denials, and working with VA representatives. Required qualifications include expert knowledge of VA claims processes and proven experience with appeals. A minimum of 2 years of experience in VA claims or medical billing is required.
Job Description
VA (Veterans Affairs) Claims Analyst
Transcend Health Solutions, LLC
Bradenton, Florida
Key ResponsibilitiesReview, submit, and monitor medical claims to Veterans Affairs, including VA Community Care, Emergent Care, CHAMPVA, and TRICARE.Verify patient eligibility and payer responsibility under VA guidelines and third-party insurance rules.
Research VA regulations and authorization criteria to ensure compliant and accurate claim submission.
Analyze denials and underpayments; draft and submit formal appeals to VA and affiliated programs.
Read and interpret EOBs and remittance advices to determine claim status and appropriate follow-up actions.
Work closely with hospitals, VA representatives, patients and third-party administrators (e.g., TriWest, Optum) to resolve outstanding claims.
Ensure all submissions follow proper documentation and are compliant with HIPAA and VA requirements.
Maintain detailed records of billing, appeals, correspondence, and claim outcomes for audit purposes.
Escalate complex cases to leadership with a proposed resolution path.
Meet productivity goals while maintaining excellent attendance, attention to detail, and accuracy.________________________________________Required QualificationsExpert knowledge of VA claims processes, including Community Care, Emergent Care, CHAMPVA, and TRICARE billing.
Proven experience reading EOBs and writing effective appeals.
Familiarity with VA portals such as HMS, TriWest, or Optum VA CCN platforms.
Strong knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and healthcare billing principles.
Excellent communication and problem-solving skills.
Detail-oriented with the ability to manage multiple priorities and deadlines.
Proven track record of excellent attendance and reliability.
High School Diploma required; Bachelors degree preferred, or equivalent combination of education and experience.
Minimum of 2 years experience in VA claims, medical billing, or claims resolution.________________________________________Preferred SkillsExperience submitting claims to VA CCN administrators (TriWest or Optum).Understanding of VA authorization and referral processes.
Familiarity with hospital lien regulations and coordination of benefits.
EHR experience.
recblid uwyq2bweq16dhbjhm94ldg51ex2qc3
Not Specified
Job Information
Position Type:
Full Time
