Claim Support Representative I

The Claims Support Representative I (CSR I) is responsible for processing medical record requests to include initiation of outbound calls and responding to incoming calls from private health care providers. Representatives must provide a high level of customer service maximize productivity perform heavy and accurate data entry of personal identifiable information review medical records and other correspondence received from healthcare providers.

Essential Duties and Responsibilities

• Act as a liaison between Veterans Private Health Care Providers and Department of Veterans Affairs to obtain medical records.
• Consistent and accurate data entry of personal health information and personal identifiable information.
• Provide medical release authorization forms to healthcare facilities to authorize release of patient private medical records.
• Communicate with healthcare providers via phone.
• Ability to interpret Department of Veterans Affairs Forms.
• Ensure all data entry is accurate and preform quality check of documents and related data within the DOMA software.
• Ability to reference interpret and apply frequent changes to VBA Private Medical Records (PMR) work instructions.
• Ability to use various databases concurrently.
• Prep scan and index US mail.
• Must maintain confidentiality at all times due to exposure to PHI & PII; must adhere to HIPAA rules and regulations.
• Meet established productivity goals and quality standards.
• Required to work outside of normally scheduled hours as mandated by client project and/or workload (i.e evenings weekends holidays and/or overtime).
• All work is performed under constant supervision

Qualifications

• High school diploma or equivalent
• One year customer service experience and working with high volume computer data entry
• Prior call center experience preferred
• Receive and maintain a favorable adjudication for a National Agency Check with Inquiries (NACI) background investigation
• Proficient in Microsoft Office Suite Adobe and computer database software
• Fluent and articulate in written and verbal English
• Positive phone presence and high focus on customer service and quality
• Able to multitask a high volume of contacts and records and navigate a computer while on the phone with customers

Additional Requirements

• Excellent communication skills: able to facilitate your own meetings as necessary comfortable working with customers as well as all levels of the organization.
• Knowledge of Windows Presentation Foundation (WPF) applications.
• Past experience with Amazon Web Services preferred.
• Knowledge of Document Imaging processes a plus (OCR/ICR Barcodes PDF Handling).
• Required to maintain established work pace meet deadlines; may have last minute urgent requests.
• Concentration may be required on various subjects by listening reading and thinking clearly
• Business interactions and behavior between coworkers and/or external customers are required. This may require facetoface or telephone interactions.
• Will be required to listen learn analyze evaluate and have the ability to interpret what is seen and/or heard or to link information from one or several things to the next.
• This is a Service Contract Act (SCA) covered position.

Work Environment/Physical Demands

The work environment and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This is an office position. While performing the duties of this job the employee regularly works in a climatecontrolled environment. Candidates must be able to sit read work on a computer and watch a computer screen for extended periods of time. Occasionally required to stand walk use hands and fingers kneel or crouch. Ability to lift and/or move boxes weighing up to 25lbs.

DOMA Technologies is an equal employment opportunity employer. All personnel processes are applied without discrimination on the basis of race color religion sex sexual orientation gender identity marital status age disability national or ethnic origin military and veteran status or any other characteristic protected by applicable law.

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