Transcend Health Solutions, LLC · 1 day ago
VA (Veterans Affairs) Claims Analyst
United States
Full-time
Remote
Entry, Mid Level
$48K/yr - $55K/yr
2+ years expTranscend Health Solutions, LLC is dedicated to maximizing claims revenue through complex claims management and certified medical coding services. They are seeking a detail-oriented VA Claims Analyst who will analyze and resolve VA-related claim issues, interpret EOBs, and ensure compliance with VA claim protocols.
Hospital & Health Care
Responsibilities
Review, submit, and monitor medical claims to Veterans Affairs, including VA Community Care, Emergent Care, CHAMPVA, and TRICARE
Verify patient eligibility and payer responsibility under VA guidelines and third-party insurance rules
Research VA regulations and authorization criteria to ensure compliant and accurate claim submission
Analyze denials and underpayments; draft and submit formal appeals to VA and affiliated programs
Read and interpret EOBs and remittance advices to determine claim status and appropriate follow-up actions
Work closely with hospitals, VA representatives, patients and third-party administrators (e.g., TriWest, Optum) to resolve outstanding claims
Ensure all submissions follow proper documentation and are compliant with HIPAA and VA requirements
Maintain detailed records of billing, appeals, correspondence, and claim outcomes for audit purposes
Escalate complex cases to leadership with a proposed resolution path
Meet productivity goals while maintaining excellent attendance, attention to detail, and accuracy
Qualification
Required
Expert knowledge of VA claims processes, including Community Care, Emergent Care, CHAMPVA, and TRICARE billing
Proven experience reading EOBs and writing effective appeals
Familiarity with VA portals such as HMS, TriWest, or Optum VA CCN platforms
Strong knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and healthcare billing principles
Excellent communication and problem-solving skills
Detail-oriented with the ability to manage multiple priorities and deadlines
Proven track record of excellent attendance and reliability
High School Diploma required; Bachelor's degree preferred, or equivalent combination of education and experience
Minimum of 2 years' experience in VA claims, medical billing, or claims resolution
Preferred
Experience submitting claims to VA CCN administrators (TriWest or Optum)
Understanding of VA authorization and referral processes
Familiarity with hospital lien regulations and coordination of benefits
EHR experience
Company
Transcend Health Solutions, LLC
Transcend Health Solutions specializes in revenue cycle management (RCM) services.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
W. Charles Day
Chief Executive Officer
Stephen Ingram
Chief Technology Officer
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