• Medical Claims Processor Lead

    Job Locations US-TX-Austin | US-TX-Waco
    Posted Date 3 months ago(8/24/2018 3:19 PM)
    Job ID
    Administrative Professional
    Overseas Travel Required
    Security Level
    Background Investigation
  • Overview

    Ansible Government Solutions, LLC (Ansible) is currently seeking full-time Medical Claims Processor (MCP) Leads for service in Austin, TX and Waco, TX. The Medical Claims Lead functions as the team supervisor and subject-matter expert for a claims area. Peformance locations include VA-FSC 7600 Metropolis Drive, Building 5, Austin, TX 78744, VA-FSC and VA-FSC Waco Medical Center 4800 Memorial Drive, Building 92, Waco, TX. Shifts may include:

    • Core Hours: Between 6:00am – 5:00pm (8-hour shift)

    • Night Hours: 4:00pm – 1:30am

    • Weekend Hours: 6:00am – 5:00pm

    • Overtime Hours: (Adhoc) Core Hours, Night Hours and Weekend Hours

     Ansible Government Solutions, LLC (Ansible) is a Service-Disabled Veteran-Owned Small Business (SDVOSB) providing Federal customers with solutions in many arenas. Our customers face wide-ranging challenges in the fields of national security, health care, and information technology. To address these challenges, we employ intelligent and committed staff who take care of our customers’ success as if it is their own.


    • Functions as the team supervisor and subject-matter expert for a claims area
    • Responsible for creating reports, distributing workload and training new employees
    • Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues
    • Investigates and initiates resolutions to complex claim problems
    • Identifies training gaps and assists employees to ensure consistent application of established guidelines
    • Identifies issues with procedures or processes and provides feedback to management on changes and development
    • Serves as liaison with other departments to address claim, system and quality issues
    • May perform some testing functions and attend/participate in meetings as needed
    • Responsible for the accurate and timely processing of medical claims in addition to their supervision duties
    • Researches and processes claims according to business regulation, internal standards and processing guidelines
    • Verifies the coding of procedure and diagnosis codes
    • Resolves system edits, audits and claims errors through research and use of approved policies, procedures or reference training materials
    • Coordinates with internal/external departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary
    • Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines
    • Determines whether to return, deny or pay claims following organizational policies and procedures
    • Corrects processing errors by reprocessing, adjusting, and/or recouping claims
    • Ensures that claims are processing according to established quality and production standards
    • Responds to routine correspondence and provides customer service support for on-line and phone call inquires and/or complaints


    • High school diploma or equivalent
    • 2 years of experience processing, researching and adjudicating medical claims

    EEO Statement

    Ansible Government Solutions, LLC is committed to providing equal opportunity in employment to all employees and applicants for employment. Ansible will not tolerate any form of discrimination or harassment based on a person’s race, religion, color, sex, sexual orientation, age, national origin, medical/physical status or disability, or military status.


    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed