Veterans Affairs Claims Processor
Who We Are
We are a leading not-for-profit health insurer in Wisconsin, and our services have grown to reach active-duty and retired military personnel, seniors, and families in Wisconsin, across the U.S., and around the world. Learn more!
WPS receives World's Most Ethical Company Award for 9th Year in a Row - 2018 Most Ethical Companies Announcement
At Our Core
WPS Health Solutions has earned a reputation as a leader in the insurance and benefits administration industry through our commitment to excellence and high-quality service. Our corporate values reflect the core of who we are and how we conduct business every day.
I recognize how my actions impact internal and external customers by being responsible for the customer experience. I look beyond the immediate issue to recognize and solve the problem.
I own my actions. I am accountable and dedicated to achieving the best results for WPS Health Solutions and our customers. I embrace my role in helping the company achieve a high-performance workplace.
I lead by example and act ethically, honestly and am trustworthy. I show appreciation for others by giving and taking constructive feedback and encouragement.
Driven and Passionate
I approach my work with enthusiasm, and personal commitment to the success of our business. I keep the importance of the work we do for our customers alive in my attitude and interactions with others, and demonstrate pride in the worthiness of our purpose.
The Veterans Affairs Claims Processor will process and develop Veteran Administration (VA) claims for missing information in accordance with VA regulations and guidelines. We also offer work from home options after training in West Frankfort, IL!
In this role you will:
- Correct payment errors on a post-processing basis, including edit resolution, credits, additional payments, statistical adjustments, and recoupments.
- Analyze claims to determine if eligibility requirements and claim filing requirements are met and make determinations.
- Contact providers/veterans for missing claim information. Add development information to claims.
- Maintain integrity of claim auditing system by identifying and reporting potential system problems. Provide examples and documentation to support findings.
- Deal tactfully with people in a wide variety of situations to convey a favorable corporate image.
* This job profile is not intended to be an exhaustive list of all duties or responsibilities associated with the job. Other job-related duties may be assigned.
You should have:
- High school diploma or equivalent
- One (1) year as a medical claims processor OR two (2) years of office experience in a customer service or insurance environment
- Ability to learn and apply VA benefits, policy, and federal regulation
- Ability to learn all VA claims processing methodologies and systems
In addition, we prefer:
- Experience with medical claims processing
- Knowledge of medical terminology, Current Procedural Terminology (CPT), and International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes
- Recent working knowledge of Facets System applications
Rend Lake College is nationally-ranked for the success and return on investment our students experience. RLC is one of the largest employers in the district.
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