About the Position: The person in this position will be responsible for resolving problems encountered with insurance billing, i.e., the initial bill which contains detailed and varied elements such as entitlements, exclusions, benefits, limitations, and similar elements. The employee must be able to identify the source of errors that prohibit the bill from being completed and submitted to the carrier. This is a Direct Hire Solicitation

Duties

Respond to numerous telephonic and written inquiries from insurance company representatives, employees, and veterans pertaining to various cost recovery requirements, policies and procedures regarding release of information and billing. Verify insurance eligibility and benefits for medical, pharmacy, dental, vision coverage; the policy type; deductible, co-payments, co-insurance amounts for preferred provider organization, Medicare Supplements. Determine primary and secondary coverage by the type of policy and plan. Determine the type of policy, i.e., Medicare or Tricare Supplement, Employer Group, Individual, Carve-Out, Indemnity, Participating Provider Network (PPO) or Health Maintenance Organization (HMO). Maintain files, directives, instructions, regulations, Federal Registers, notices, and correspondence related to programs. Brief, train and/or assist clinic, ancillary personnel periodically, on how to obtain insurance registration from patient and on revised system procedures. Utilize general office automation software to develop individual letters/memoranda inherent to the assignment.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This is a Financial Management Level I Certified position. Employees in this position are required to comply with all Department of Defense and Department of the Army requirements of this certification program.

Qualifications

Who May Apply: US Citizens In order to qualify, you must meet the education and/or experience requirements described below. 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; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Specialized Experience: One year of specialized experience which includes identifying and/or verifying customer's eligibilities and benefits; resolving problems encountered with insurance billing; explaining billing procedures and/or entitlements to customers; utilizing general office automation software to develop reports and/or memorandums; and maintaining records for customer files. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-04). OR Education: Four years of education above the high school level obtained in an accredited business, secretarial or technical school, junior college, college or university. OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide your semester hours of education beyond two years (total semester hours minus 60) by 60. Add the two percentages.

Education

FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address JT-DHA-DD83CK DHA STAND-ALONE MKT-IRWIN ACH DO NOT USE Fort Riley, KS 66442 US
• Name: Army Applicant Help Desk