SteerBridge ยท 4 months ago
Veterans Affairs Claims SME
Vienna, VA
Full-time
Onsite
Mid Level
$145K/yr - $155K/yrSteerBridge Strategies is a CVE-Verified Service-Disabled, Veteran-Owned Small Business delivering professional services to the U.S. Government and private sector. They are seeking an experienced Program Assurance and Quality Specialist to support the Modern Disability Claims program for the U.S. Department of Veterans Affairs, focusing on evaluating the accuracy and integrity of automated adjudication outcomes.
GovernmentInformation TechnologySoftware
Responsibilities
Evaluate automated claims adjudication outcomes to ensure accuracy, completeness, and compliance with VA policies, regulations, and adjudication standards
Develop and maintain process maps and data workflows to ensure claims automation reflects current VA procedures and supports accurate, standards-based outcomes
Collaborate with IT and data teams to translate VA claims development procedures into automated logic. Validate outputs against established adjudication rules to ensure reliable and compliant automation
Review medical records, service documentation, and prior rating decisions to assess system behavior, support ACE determinations, and inform appropriate development or proposed approval/denial actions
Assist in shaping the structure and content of digital claims documentation to ensure it supports accurate downstream adjudication, quality assurance, and appeals processing
Track legislative and VA policy changes to ensure automated systems and business rules remain current and compliant
Deliver training and guidance to cross-functional stakeholders, ensuring alignment with VA benefits policy, claims protocols, and quality standards
Maintain strict confidentiality and ensure the secure handling of sensitive Veteran data in accordance with VA privacy and cybersecurity requirements
Qualification
Required
Evaluate automated claims adjudication outcomes to ensure accuracy, completeness, and compliance with VA policies, regulations, and adjudication standards
Develop and maintain process maps and data workflows to ensure claims automation reflects current VA procedures and supports accurate, standards-based outcomes
Collaborate with IT and data teams to translate VA claims development procedures into automated logic
Validate outputs against established adjudication rules to ensure reliable and compliant automation
Review medical records, service documentation, and prior rating decisions to assess system behavior, support ACE determinations, and inform appropriate development or proposed approval/denial actions
Assist in shaping the structure and content of digital claims documentation to ensure it supports accurate downstream adjudication, quality assurance, and appeals processing
Track legislative and VA policy changes to ensure automated systems and business rules remain current and compliant
Deliver training and guidance to cross-functional stakeholders, ensuring alignment with VA benefits policy, claims protocols, and quality standards
Maintain strict confidentiality and ensure the secure handling of sensitive Veteran data in accordance with VA privacy and cybersecurity requirements
Benefits
Health insurance
Dental insurance
Vision insurance
Life Insurance
401(k) Retirement Plan with matching
Paid Time Off
Paid Federal Holidays
Company
SteerBridge
SteerBridge specializes in providing professional services and cutting-edge solutions to the U.S. Government and corporate clients.
Founded in 2011
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Doug Lee
Partner
Rob Schroder
Founder and Managing Partner
Recent News
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