Reimbursable Billing Technician

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/15/2024. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. For a GS-6 position you must have served 52 weeks at the GS-5. For a GS-7 position you must have served 52 weeks at the GS-6. You may qualify based on your experience and/or education as described below: GS-6 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Provides customer service to meets the needs of the customer. Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence. Identifies, reviews, analyzes, process and completes co-payments and insurance encounters and other billing related activities. Independently reviews and processes all specialty billing encounters. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing. GS-7 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-06 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Provides customer service to meets the needs of the customer. Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence. Initiates, gathers, and processes 3rd party revenue actions related to legal case activities by applying appropriate and relevant guidelines. Researches and recognizes data for dialysis billing to 3rd party insurance companies using a specified patient claims information system database. Conducts assigned ad hoc corrective projects, answers questions, and solves agency revenue account problems. Assists in synchronizing and the operationalization of all revenue activities. Accesses various menu options to identify, review, analyze, process and complete co-payments and insurance encounters and billing related activities. You will be rated on the following Competencies for this position: Customer Service (Clerical/Technical) Insurance Organizational Awareness Technical Competence Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements: The work is performed mainly in a sedentary manner. Occasional walking, standing, reaching, and bending are required. The carrying of light items such as paper, folders, and files between desk and storage is common. The work requires long periods of interaction at computer terminals. For more information on these qualification standards, please visit the United States Office of Personnel Management’s website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
This position is in a Veteran Affairs Medical Center (VAMC) facility aligned with a Consolidated Patient Account Center (CPAC) organizationally under the Chief Operating Officer (COO). The CPAC is a regionally consolidated business entity established to enhance revenue within Veterans Health Administration (VHA) using an industry best model built on regional management of key aspects of the revenue cycle, process standardization, accountability, and economies of scale.