Claims Rejection Resolution and Appeals Management

The contract seeks a subcontractor to resolve 100 percent of rejected insurance claims within five business days by conducting root cause analysis, resubmitting corrected claims, and coordinating effectively with insurers and Veterans Affairs staff in full compliance with VA policies. This effort requires precise, timely action to ensure claims are accurately processed and appealed as needed, minimizing delays and maximizing reimbursement for veteran healthcare services. The subcontractor must demonstrate proven experience in healthcare claims adjudication, deep familiarity with VA protocols, and the capacity to maintain rigorous turnaround times under high volume conditions. The opportunity is classified under NAICS code 541611 and is posted by the Department of Veterans Affairs through the PCAC contracting office with a response deadline of July 20, 2026. The solicitation does not specify a set-aside type or organizational eligibility restrictions, and the place of performance is not defined, suggesting work may be performed remotely or at designated VA facilities. Interested parties must submit proposals before the deadline to be considered for this critical support role in improving claims efficiency and veteran care outcomes.