This position is located in the Physical Therapy Department at Hopi Health Care Center in Polacca, AZ. The incumbent serves as office personnel for the therapy department to assist in coordination and implementation of contact representatives duties, therapists' schedules, paraprofessional schedules, office responsibilities, and billing under guidance of the supervision of Supervisory Physical Therapist.

Duties

This position is being re-advertised to solicit additional applications. Applicants who applied previously need not reapply unless submitting updated and/or missing information. Determines the eligibility of patients seeking health care, who have not previously been treated at the facility, by obtaining the certificate of Indian Blood or other documentary proof of tribal membership, according to the IHS guidelines. Works closely with all staff in the identification and utilization of all alternate resources available to the Native American population. Establishes eligibility of potential Medicare eligible by working with the Social Security Administration (SSA), on both the local and regional levels. Performs a variety of patient representative functions, such as; (1) continuous research, reviews, analyzing and updating of information involving changes in rules and regulations for alternate resources; and (2) interpreting rules and regulations for alternate resources for patients. Ensures timely entry of all private insurance, AHCCCS and Medicare information to augment outpatient and inpatient billing efforts and DME services. Responsible for Medicare claims upon receiving, until claim has been paid by Third Party Payor. This includes responsibility of denials and appeals. Conducts a thorough review of all abstraction and search of records and/or guidelines in order to select the most accurate and descriptive codes in accordance with CPT/HCPCS coding system. Reviews reports and listings to assure that they are in balance, proper format, sequenced and that accounting data is valid. Responsible for automated transmission of all third-party claims.

Requirements

Qualifications

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. Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed, annual salary, and description of job duties. Include name and address of employer; supervisor name and telephone number. MINIMUM QUALIFICATIONS, GS-0962-07: 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: Examples include: Determines the eligibility of patients seeking health care, who have not previously been treated at the facility, by obtaining the appropriate documents according to guidelines and regulations. Identification and utilization of alternate resources available to the patient; Ensure timely entry of all private insurance, AHCCCS and Medicare information to augment outpatient and inpatient billing efforts; Receive and examine alternate resources to assure claims are complete with appropriate supporting documents; Search and abstract CPT coding: operative, DME, therapeutic and all other pertinent data from the medical records to identify and document appropriate patient care and other information necessary for billing; Batches bills and prepares amount patient bills, responsibilities related to automated transmission of all third-party claims. MINIMUM QUALIFICATIONS, GS-0962-08: 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: Examples include: served as an advocate for patients in the effective utilization of alternate resources such as Medicare, Medicaid, Department Veterans Affairs (DVA), Bureau of Employment Compensation (BEC), Third Party Liability, Children's Special Health Services, Aid to Families with Dependent Children (AFDC), etc.; Determines the eligibility of patients seeking health care; Work with patient registration/receptionists in screening for potential eligible patients; responsibility for claims upon receiving, until claim has been paid by Third Party Payor, Receives and examines alternate resources to assure claims are complete with appropriate supporting documents; auditing the appropriate and correct Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) codes. 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.

Education

This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation.

If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address HOPI HEALTH CARE CENTER PO Box 4000 Polacca, AZ 86042 US
• Name: Travis Yellowhair
• Email: [email protected]