This position is located within the Patient Business Services Department at the Phoenix Indian Medical Center, in Phoenix, AZ. The incumbent serves as the Supervisor of the Accounts Receivable and Denial Management Sections. The primary function of these Sections is to assure an efficient system of timely posting and follow up on claims denied or not paid in full. Timely accurate posting and follow up of claims is critical to the enhancement of the revenue cycle management.

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. Responsible for directing the activities of the Accounts Receivable and Denial Management Sections. Performs long and short range planning, evaluation, and analysis; and projection of future resource requirements. Reviews and monitors workload; Trains, develops, and orientates subordinates; and interprets regulations, requirements, and procedures. Develops and implements a comprehensive internal quality control system that measures the effectiveness of such controls and their impact on the program. Performs a variety of accounts receivable and denial management functions such as: examination, verification and maintenance of data involved in processing payment, denials and partial payments from alternate resources; determines the eligibility of patients in accordance with IHS and Phoenix Area Guidelines; obtains and verifies alternate resources data necessary for payment, partial payment or denial of claims; interprets rules and regulations for alternate resources for patients; and performs continuous research and updates information involving changes in rules and regulations for alternate resources. Applies extreme discretion when considering possible entitlement to available programs. Utilizes patient data base information to process payments and/or denials to alternate resources. Exercises delegated authority to decide in cases of debt collections to be sent forward to Area Office personnel.

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. Individual Occupational Requirements, GS-0671: Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS, GS-11: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-09 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: Comprehensive responsibilities as a supervisor to include: directing the activities of the Accounts Receivable and/or Denial/Accounts Management functions, perform long and short range planning, evaluation, and analysis; and projection of future resource requirements, personnel administration, provide training, development, and orientation of new and existing employees, and continuous quality improvement; Performed a variety of accounts receivable and denial/accounts management functions such as: examination, verification and maintenance of data involved in processing payments, denials and partial payments from alternate resources; Determines the eligibility of patients; Identify and analyze issues, problems and challenges facing the revenue cycle management; Evaluate and compile data of denied claims and analyzes status reports for review to Management. OR Completed a Ph.D. or equivalent doctoral degree or 3 full years (54 semester hours) of progressively higher level graduate education leading to such a degree, such education must demonstrate the knowledge, skills, and abilities necessary to do the work or LL.M., if related. OR Combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-11 grade level. 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 Phoenix Service Unit 1616 E Indian School Rd Suite 360 Phoenix, AZ 85016 US
• Name: Yanibah Yazza
• Email: [email protected]