VA Claims Follow-Up Specialist

Syntriq Health Solutions; Corinth (MS); On-site; USD 42,000 - 64,000; Full time

Job summary

Syntriq Health Solutions in Corinth, MS is seeking a VA Claims Follow-Up Specialist to ensure timely, accurate resolution of Veterans Administration hospital claims by monitoring status, addressing denials, and maintaining compliance with VA policies.

You will track claims in systems like HSRM and eCAMS, coordinate with VA representatives and TPAs, and generate reports on aging, payment variances, and resolution timelines.

Qualifications

• Knowledge of VA billing processes (CCN and VCA) required.
• Familiarity with UB-04 and CMS-1500 claim forms.
• Experience with electronic billing systems and portals (eCAMS, Epic).
• Excellent communication and problem-solving skills are essential.

Responsibilities

• Monitor VA hospital claims through systems like HSRM and eCAMS Provider Portal.
• Verify receipt of claims and follow up with VA representatives and TPAs (Optum, TriWest).
• Confirm VA authorizations for inpatient and outpatient services; ensure emergency care within 72 hours when applicable.
• Investigate and resolve denials related to eligibility, missing authorizations, or medical necessity; prepare appeals.

Skills

VA billing processes

UB-04 & CMS-1500

Electronic billing systems

Communication skills

Problem-solving

Tools

Epic

eCAMS

Provider Portals

Job description

Job Details

Job Location: Corinth, MS 38834

Position Type: Full Time

Education Level: Not Specified

Travel Percentage: None

Job Shift: Day

The VA Claims Follow-Up Specialist will ensure timely and accurate resolution of Veterans Administration hospital claims by proactively monitoring claim status, addressing denials, and maintaining compliance with VA policies and federal regulations.

Key Responsibilities

• Claim Monitoring & Status Updates
  • Track VA hospital claims through systems like HSRM (HealthShare Referral Manager) and eCAMS Provider Portal.
  • Verify receipt of claims and follow up with VA representatives and Third-Party Administrators (TPAs) such as Optum or TriWest
• Authorization & Documentation
  • Confirm VA authorizations for inpatient and outpatient services.
  • Ensure the hospital requested an emergency care within 72 hours when applicable.
• Denial Management
  • Investigate and resolve denials related to eligibility, missing authorizations, or medical necessity.
  • Prepare appeals and submit supporting documentation as required.
• Communication
  • Provide timely updates to internal teams and
• Reporting
  • Generate reports on claim aging, payment variances, and resolution timelines.
  • Use Epic or similar systems for real-time account updates.

Qualifications

• Strong knowledge of VA billing processes, Community Care Network (CCN), and Veterans Care Agreements (VCA).
• Familiarity with UB-04 and CMS-1500 claim forms.
• Experience with electronic billing systems and portals (e.g., eCAMS, Epic).
• Excellent communication and problem-solving skills.