Claims Assistant

Claims Assistants serve as the initial reviewers for compensation and pension claims. Claims Assistants are responsible for the care and maintenance of the claims folders, analyzing the claim, and determining if the disposition of the claims and control action have been appropriately identified. These employees develop straightforward evidence in conjunction with claims, establish or update control action, and facilitate workflow between the team and other Veterans Service Centers (VSC). These professionals are valuable members of the VA team which ensures that claims are processed so Veterans receive the benefits they have earned through their service.

Job Duties

  • Provides high quality customer service by determining the best approach for handling issues
  • Processes applications and associated documents and inputs information into the database 
  • Provides information to the public on rights, benefits, privileges, or obligations under body of law

Knowledge Areas

Need to have a thorough understanding of:

  • Claims processing phases (i.e., public contact, triage, pre-determination, and development)
  • Communication techniques appropriate for a wide diversity of audiences
  • VA laws, rules, regulations, and policies governing claims, benefits, and eligibility
  • Contents and maintenance procedures for claims folders
  • Mail (information and evidence) processing
  • Research methods for information related to laws, rules, and policies
  • Applicable electronic data processing and tracking systems (e.g., COVERS, VACOLS, and RBA 2000)
  • Policies and procedures regarding privacy and release of information

Education and Licensure

  • No mandatory requirement

Training & Developmental Experiences

Entry

Grade Range: 4-6

Developmental Experiences

  • Distribute mail to the appropriate team upon entry to the office
  • Schedule a hearing on an appeal case
  • Establish initial control on a CLCW or fast track claim
  • Access CAPRI to print medical records from a VA medical center
  • Establish the appropriate control of a compensation claim
  • Communicate with Federal archives records centers to transfer retired folders
  • Create a new folder for a claim after determining that one does not yet exist
  • Process a Freedom of Information Act (FOIA) request

Training Resources

* This is an internal Department of Veterans Affairs training opportunity provided to VA employees for continued career growth. Some courses may not be available if they are not in a person’s learning plan or catalogue.

Professional Associations

Membership in professional organizations can be useful in maintaining an awareness of developments in the field. These organizations are examples of associations aligned with this position:

Career Fit

Work Interest

Work Interests refer to the types of work activities that interest you, such as interacting with people, thinking of new ideas, or working with your hands. The chart below shows the Work Interest Profile for this job.

Work Environment

Work Environment refers to the setting in which you like to work, such as inside or outside, in a competitive or supportive environment, or in an environment with a little or a lot of time pressure. The chart below shows the Work Environment Profile for this job.

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