Role Description The VA Claims Specialist will investigate health insurance claims and bills to ensure claims resolution. Responsibilities include: - Following up on unresolved claims - Facilitating payment of claims for Veterans' Affairs and its affiliates Training: - Comprehensive training begins on your first day and lasts 8-10 business days - Led by instructors with interactive discussions and hands-on activities - Participation is essential for success Qualifications - Working knowledge of Microsoft Office (Word, Excel, Outlook) - Technical proficiency to work on multiple computer screens and software applications simultaneously - Ability to maintain strong performance in a fast-paced environment with productivity metrics - Organizational skills while multi-tasking - Critical thinking and problem-solving skills - Clear communication skills, both verbally and in writing - Investigative mindset - Experience in a professional office environment - General understanding of insurance billing (a plus, but not required) - Experience with billing and appealing denied health claims (a plus, but not required) Requirements - A private, distraction-free environment to work within your home - On-Camera Presence: Being on camera is essential for building trust and collaboration - A secure internet connection - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads - Workspace must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset) - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check Benefits - Paid training and incentive plans - Medical, dental, vision, and life insurance benefits available on day 1 - Excellent work/life balance - Employee Resource Groups build community and foster a culture of belonging and inclusion - 401(k) contributions matched - Career growth opportunities - 12 paid holidays and generous paid time off

• Communicating directly and following up with insureds to perform loss adjustments, pre-acceptance or quality control inspections to gather facts involved with the settlement of reported claims or inspections • Staying abreast of crop insurance industry procedures relating to proper adjustment of claims • Analyzing and making recommendations for enhancements for company software products to assure compliance with company and RMA procedures • Performing claim audits and reviews

• Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims. • Review, apply and create refund letters for all lines of business to members and providers. • Reprocess payments when necessary. • Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions. • Review plan documents for various groups to research and resolve claim processing questions and issues. • Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request. • Perform other related duties, as assigned.

• Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims. • Review, apply and create refund letters for all lines of business to members and providers. • Reprocess payments when necessary. • Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions. • Review plan documents for various groups to research and resolve claim processing questions and issues. • Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request. • Perform other related duties, as assigned.