• Medical Claims Processor

    Job Locations US-TX-Austin | US-TX-Waco
    Posted Date 3 months ago(8/24/2018 3:22 PM)
    Job ID
    2018-1259
    Category
    Administrative Professional
    Overseas Travel Required
    No
    Security Level
    Background Investigation
  • Overview

    Ansible Government Solutions, LLC (Ansible) is currently seeking full-time Medical Claims Processors (MCP) for service in Austin, TX and Waco, TX.

    The MCP is responsible for the accurate and timely processing of medical claims. 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.

    Responsibilities

    • Responsible for the accurate and timely processing of medical claims
    • Researches and processes claims according to business regulation, internal standards and processing guidelines
    • Verifies the coding of procedure and diagnosis codes
    • 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
    • Performs research on claim problems by utilizing approved policies, procedures, reference training materials, forms and coordinates with various internal support areas
    • Corrects processing errors by reprocessing, adjusting, and/or recouping claims
    • Ensures claims are processed according to established quality and production standards
    • Assists the lead medical claims processor in training or mentoring new staff members
    • Responds to routine correspondence and provides customer service support for on-line and phone call inquires and/or complaints

    Qualifications

    • High school diploma or equivalent
    • 1 year 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.

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