Indian Health Service - Department of Health and Human Services
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: Minimum Qualifications for GS-06:Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Billing the applicable agency for services provided to a patient, responding to third party requirements on post-payment reviews, exclusions, denials and appeals, providing orientation and training to appropriate personnel, verifying that medical records contain proper documentation in accordance with regulations and monitoring inpatient daily census on a concurrent basis. Minimum Qualifications for GS-07: 1 Year of Specialized Experience equivalent to the GS-06 Grade Level OR 1 Year (18 semester hours) of graduate education that is directly related to the work of the position. Specialized Experience is defined as experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA’s) to perform successfully the duties of the position, and that is typically in or related to the position to be filled. Examples include: Submitting claims to third party payers and responsible parties, rebilling or correcting billing of accounts previously submitted, verifying information, reviewing reports to identify claims and using the various types of computer systems and searching and retrieving individual patient records to gather and compile information for outpatient services. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.
The position manages & coordinates the operations of the reimbursement program with Medicaid, Medicare, Private Insurance & others that are in compliance with HIPAA & other requirements. Provides registration & eligibility services which are the key point of interaction with patients to obtain & process demographic & insurance information for alternative resources, Purchased Referred Care & pertinent health information. Works with RPMS automated & electronic Billing & Accounts Receivable Program