Home Claim Processor

Position Summary

The Home Claim Processor is responsible for processing Child and Adult Care Food Program (CACFP) claims for participating daycare home providers. This position reviews electronic and manual claims for accuracy, compliance, and completion while assisting providers with technical assistance, documentation corrections, and claim related support.

The Home Claim Processor helps ensure claims are processed accurately and timely in accordance with USDA, CACFP, state agency, and organizational requirements.

• Reports to: Home Program Administrator
• Department: CACFP Homes Program
• FLSA Status: Non Exempt
• Employment Type: Part Time
• Schedule: M-F 1st-15th of each month

Essential Duties and Responsibilities

Electronic Claim Processing

• Review electronic CACFP claims to minimize errors prior to final claim processing.
• Review Office Error Reports and identify claim issues requiring correction.
• Review menus for CACFP meal pattern compliance.
• Verify required standardized recipes are maintained for applicable menu items.
• Verify required CN labels and product formulation statements are maintained when applicable.
• Reprocess claims and reports as needed to correct errors and ensure claim accuracy.
• Credit providers for meals or items disallowed in error when appropriate.
• Maintain claim processing checklists and verify claims have received required reviews prior to submission.

Manual Claim Processing

• Verify providers have submitted complete monthly documentation including:
  • Menus
  • Meal counts
  • Attendance records
• Pull required child list and supporting reports from organizational systems.
• Review and document:
  • License expiration dates
  • License capacity
  • Income eligibility expiration dates when applicable
• Review menus for CACFP meal pattern compliance.
• Verify required standardized recipes are maintained for applicable menu items.
• Verify required CN labels and product formulation statements are maintained when applicable.
• Identify and mark disallowed meals or noncompliant menu items.
• Review attendance and meal count forms for accuracy and completeness.
• Calculate attendance and meal count totals accurately.
• Ensure claims receive required secondary review prior to submission.
• Enter meal totals and claim errors into Kidkares accurately.
• Send Office Error Reports and correction notices to providers.
• Maintain claim processing checklists and tracking documentation.

Compliance Review and Technical Assistance

• Provide technical assistance to providers regarding:
  • CACFP meal pattern requirements
  • Recordkeeping requirements
  • Menu compliance
  • Meal counts and attendance
  • Recipes and CN labels
  • Claim processing procedures
• Assist providers with correcting claim errors and documentation deficiencies.
• Respond to provider questions regarding claim processing and CACFP requirements.
• Support providers in maintaining organized and compliant CACFP records.

Provider Documentation and Administrative Support

• Update provider profiles and records following approved application changes from the state agency.
• Send provider emails, letters, and compliance related communication as needed.
• Maintain organized electronic and administrative records related to claim processing.
• Assist with operational and administrative CACFP duties as assigned.
• Participate in staff meetings, trainings, and organizational activities as required.

Qualifications

• High school diploma or equivalent required.
• Associate's degree in Business Administration, Early Childhood Education, Nutrition, Accounting, or related field preferred.
• Experience in administrative support, claim processing, childcare administration, or compliance review preferred.
• Experience with Google Workspace, Microsoft Office, and Adobe Acrobat preferred.
• Strong computer, organizational, and data entry skills required.

Knowledge, Skills, and Abilities

• Strong attention to detail and accuracy.
• Ability to review records and documentation for compliance.
• Strong organizational and time management skills.
• Strong communication and customer service skills.
• Ability to manage multiple deadlines and assignments.
• Ability to maintain confidentiality of provider and child information.
• Strong problem solving and follow up skills.
• Ability to work independently and collaboratively.

Physical Requirements

• Ability to sit and work at a computer for extended periods.
• Ability to review electronic and paper documentation regularly.
• Ability to occasionally lift and carry files, office supplies, and training materials up to 25 pounds.

Compensation and Benefits

• Pay: From $15.00 per hour
• Benefits: Flexible schedule, retirement plan, and work from home options.

Disclaimer

This job description is intended to describe the general nature and level of work being performed by the employee assigned to this position. It is not intended to be an exhaustive list of all responsibilities, duties, and qualifications required. Responsibilities may be modified based on organizational and program needs.