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Claims Analyst

Employer
Quality Care for Children
Location
Atlanta, GA office with flexibility for some home-based work
Salary
$39,000 - $46,000 
Closing date
Apr 26, 2024

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Focus Areas
Education, Healthcare, Human Services
Job Function
Direct Service / Social Service
Position Type
Full Time
Degree Level
Bachelors

Job Details

Quality Care for Children Child and Adult Care Food Program

Child and Adult Care Food Program

QCC is an Equal Opportunity Employer and does not discriminate against applicants due to age, race, ethnicity, national origin, religion, gender, sexual orientation, disability, or any other federal, state, or local protected class.  

Claims Analyst 

Department: Nutrition Services 

Supervisor: Assistant Director of Claims and Procurement 

Salary Range: $39,000 - $46,000 

POSITION SUMMARY 

The Claims Analyst is responsible for the review, adjustment and compliance monitoring of document submissions made by operators of a federal-funded meal program for children. The analyst works directly with directors and owners of child care facilities and conducts monthly desk audits prior to the issuance of reimbursement to each site. An ideal candidate must be detail oriented, organized, and able to multitask. Additionally, the claims analyst must be very communicative by calls, teleconferencing, and emails while maintaining superb customer service skills and actively listening. The position entails the use of a well-known industry software (KidKare), Microsoft Office (Excel, Word, Outlook), Citrix and other platforms.  

RESPONSIBILITIES 

Claims processing and Offsite Monitoring for Compliance 

  • Use independent judgment to determine if sites are complying with federal regulations and program guidelines 
  • Make recommendations for noncompliance determinations using evidence from offsite monitoring in conjunction with site monitoring reviews conducted by Nutrition Program Consultants (monitors) 
  • Coordinate claim processing with child care centers 
  • Reconcile expense and enrollment documentation and discern the credibility of evidence provided by the center 
  • Make claim adjustments during the reconciliation process 
  • Coordinate claims processing with staff 
  • Review claim reports relevant to monthly claims 
  • Create claim file to disseminate to each site (centers only)  

Maintenance of records and database 

  • Maintain adequate records in database and physical file 
  • Update provider file with any new changes 

Monitoring, Technical Assistance and Training 

  • Conduct onsite monitoring visits with Nutrition Program Consultants as needed 
  • Conduct onsite follow-up monitoring visits as needed 
  • Examine site monitoring reviews for accuracy  
  • Offer phone technical assistance as needed 
  • Provide technical assistance to sponsored centers and homes 
  • Conduct Child and Adult Care Food Program orientation and other training as needed 

Administrative 

  • Parental/household contacts for attendance and enrollment verification 
  • Perform these duties with the understanding that responsibilities and tasks may be modified or expanded over time 

REQUIREMENTS 

  • Minimum three (3) years of relevant work experience 
  • Bachelor’s degree is required; a degree in a related field is preferred 
  • Good knowledge of child care standards and practices 
  • Skilled customer service 
  • Excellent communication, organizational and decision-making skills 
  • Ability to keep accurate records 
  • Proficient in Word, Excel, PowerPoint, and Outlook 
  • Self-directed with the ability to work independently 
  • Flexible schedule with occasional evening and weekend duties 
  • Exemplary ethics, professional manner and appreciation of the mission of QCC 

PHYSICAL DEMANDS/WORK ENVIRONMENT 

  • Occasional driving 
  • Valid driver’s license and dependable transportation required 
  • Consistently standing for two hours or more delivering training 
  • Sitting at the computer for hours 
  • Work occasional nights and weekends 
  • Bending, frequent use of hands, stooping, kneeling, and moderate lifting (at least 25 pounds) required 
  • Noise level in the work environment may be high at times 

ADDITIONAL INFORMATION: Quality Care for Children's Atlanta office is the base location for this position, with flexibility for some home-based work. 

To Apply 

Please e-mail HR@qualitycareforchildren[dot]org your resume and 1-page cover letter (list applied position in the e-mail's subject line). Please include your name when titling email attachments.  

Resumes will be accepted until the position is filled.  No phone calls please. 

Company

QUALITY CARE FOR CHILDREN OVERVIEW

For more than 40 years, Quality Care for Children's mission has been to ensure that Georgia’s infants and young children are nurtured and educated so that every child can reach their full potential by helping:

  • child care programs provide nutritious meals and educational care to young children so they are ready for success in school,
  • parents access quality child care so that they can attend college or succeed in the workplace.
Company info
Website
Telephone
404.479.4200
Location
3 Corporate Blvd. NE, Suite 230
Atlanta
GA
30329
US

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