Junior Analyst, CRSC Claims

Job Description

Job Description

Purpose of the Position:

CRSC Benefits Analyst reviews and analyzes claimants' applications and recommends claim disposition to Army client, while serving Soldiers in accordance with Army and OSD policies, time standards, and procedures.

Duties and Responsibilities:

Reviews, research, and recommend disposition of CRSC claims based on eligibility and documentation provided by applicants. Utilizes Government systems and other sources of information to conduct claims research and create accompanying decision letters. Processes claims in accordance with contract quality and time requirements. Follows HIPAA guidelines and disposes of documentation not needed for determination of CRSC benefits. Enters information regarding claim decisions into Soldier Management System (SMS) database and reviews claims processed by peers to assure quality of work products and deliverables. Creates letters for claims to be sent to adjudication for approval. Follows HIPAA guidelines and disposes of documentation not needed for determination of CRSC benefits. Enters information regarding claim decisions into iPERMS Case Management database and reviews claims processed by peers to assure quality of work products and deliverables. Other duties assigned.

Minimum Qualifications/Competencies:

Functional knowledge of CRSC application forms (DD Form 2860 and 12e), applicable laws, DoD policy, and CRSC SOPs. Possesses NACI security classification and adheres to internal security guidelines and procedures. Strong working knowledge or experience with Microsoft Office products, including Word, Excel, SharePoint, and PowerPoint. Capabilities to research medical and personnel records; understand military and medical acronyms; have an understanding or knowledge of military unique equipment, training and/or weaponry; and have a moderate level of logical reasoning and writing skills. Knowledge and comprehension of performance standards outlined in the Performance Work Statement (PWS).

Performance/Standards of Measure:

Proven knowledge of CRSC regulatory and program guidance. Adheres to 100 percent accountability of claims processed. Competency in applicable Army systems (SMS and iPERMS). Proven knowledge of subject matter is contained in CRSC Procedure's Guide. Able to gain access and use applicable Army automated personnel database systems (iPERMS, SMS, JLV, VBMS, and related programs).

Employees are to meet their daily quota for processing claims per the established performance standards.

- CRSC Team: Process a minimum of 3,000 CRSC cases per quarter/12,000 CRSC cases per year.

- CRSC Analyst: Process an average of 5 CRSC case per day/ 100 CRSC per month.

a. Timelines: 95 percent of cases processed IAW PWS part 5 established timelines.

b. Quality: 95 percent of cases are accurate upon completion.

c. Completeness: 95 percent of cases are complete upon completion.