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Claim Review Assessor

Employer
PAE
Location
Washington, DC
Closing date
Nov 26, 2020

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Industry
Insurance
Function
Accountant, IT
Hours
Full Time
Career Level
Experienced (Non-Manager)
Supporting the Most Exciting and Meaningful Missions in the WorldClaim Review AssessorThe September 11th Victim Compensation Fund ("VCF") was created to provide compensation for any individual or personal representative of a deceased individual who suffered physical harm or was killed as a result of the terrorist-related aircraft crashes of September 11, 2001 or the debris removal efforts that took place in the immediate aftermath of those crashes. The original VCF operated from 2001-2004. In 2011, the James Zadroga 9/11 Health and Compensation Act of 2010 was signed into law and reactivated the September 11th Victim Compensation Fund in October 2011. In July 2019, the Fund was reauthorized permanently. More information about the VCF can be found at https://www.vcf.gov/. The Claim Review Support Team works with VCF and claim review leadership to support all aspects of claim review team work with a particular emphasis on claim and data management, claim assessment, knowledge management and training coordination. Working closely with respective claim review team leads and supervisors and, under the supervision of the Claims Manager, the Claim Review Assessor performs pre-screen, claim preparation, administrative checks, feed management and special projects for the claim review teams while complying with established VCF Standard Operating Procedures. Duties and ResponsibilitiesThe Claim Review Assessor's responsibilities include:Pre-screen: Responsible for "pre-screening" claims at the eligibility, compensation, and amendment stages. This includes deactivating claims and dispositioning amendments as needed, and identifying and entering appropriate missing information requests and placing claims on feeds.Feed management: Responsible for compiling presence and compensation feed requests, and manages special feed requests by review team.Claim Preparation: Populates claim review worksheets and claim summary templates, including incorporating data from the initial checks completed in pre-screen. Administrative Checks: Performs administrative checks prior to peer review or production of the claim to a decision maker in conjunction with the claim reviewer.Special Projects: Works on special projects as assigned, focusing on claim review and coordination. Examples include tracking appeals in conjunction with the hearings team, assisting in the tracking of NIOSH disability evaluation requests, coordinating with NIOSH on private physician verifications, tracking of Congressional interest or other claims with unique circumstances, and other projects as needed. CompetenciesUnderstands tasks, task objectives and the context of those tasks in the claim review lifecycleHas a collaborative nature and is comfortable coordinating across teams and with various managers, supervisors, and team membersComfortable working in an environment with high volume inputs, outputs, and deadlinesPassionate about attention to detail, deadlines and work qualityHighly organized, able to multi-task, prioritizes tasks and consistently and accurately performs detailed work under pressure without compromising qualityProactively identifies issues that impact claim review coordination and proposes alternate solutions to address issuesHas excellent typing/keyboarding skills and written and oral communication capabilities QualificationsBachelor's degree with a minimum of 3 years' related experience or Master's degree; paralegal certificate preferred but relevant experience may be substituted with the approval of the Contracting Officer.Proficient with MS Excel (intermediate user or higher), MS Access and other Microsoft Office suite productsStrong research and auditing skillsExperience in claim management or processing environmentExperience in government programs or litigation support preferred Reporting RelationshipsReports to the Claim Review Support Team Project ManagerPAE is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran's status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.EEO is the Law PosterEEO is the Law Poster Supplement

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