These positions are aligned under the Veterans Health Administration Office of Finance and are physically located in Orlando, Florida at the Consolidated Patient Account Center (CPAC), Billing and Insurance Verification Department. The Medical Reimbursement Technician performs a broad range of duties to achieve the established Central Office VISN expected results for medical billing and reimbursable/non-reimbursable collections.

Duties

***THESE ARE NOT VIRTUAL POSITIONS, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** NOTE: These positions involve a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. Duties include, but may not be limited to the following: Performs verification of patients' insurance coverage for inpatient/outpatient services; Enters information into medical database and generates reports; Documents pre-admission requirements and identifies patients requiring second opinions; Performs reimbursement medical billing activities, including consideration of professional and facility services, sharing agreements, Tricare, Champ VA, Medical, and Pharmacy billing; Validates claims for medical billing purposes to ensure eligibility and refers questionable coding for review; Monitors reports to assure all possible billable cases are processed; Ensures proper sequencing of medical diagnostic and procedural codes; Tracks, reviews, and corrects health insurance denials; Performs third-party collections from health insurance companies, including humanitarian, Department of Defense, Tricare, workman's compensation, etc.; Performs research, resolves problems, and posts medical payments, adjustments, denial codes, and non-payment collections; Verifies accuracy of third party payments, resolving discrepancies and closing, auditing accounts; Communicates with health insurance companies and patients, answering questions/inquires; Explains health care services eligibility and entitlements to patients; Provides input for responding to Congressional inquiries; Performs other related duties as assigned. Work Schedule: Full Time, Monday through Friday, 8:00am to 4:30pm Recruitment & Relocation Incentives: Not authorized Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Financial Disclosure Report: Not Required

Requirements

Qualifications

To qualify for this position, you must meet one of the following: SPECIALIZED EXPERIENCE: Applicants must possess at least one (1) full year of specialized experience equivalent to at least GS-4 grade level in Federal Service that has equipped you with the knowledge, skills, and abilities necessary to perform the duties of a Medical Reimbursement Technician GS-5. Specialized experience includes performing healthcare reimbursement; verifying insurance information for inpatient and outpatient services;reconciling accounts; ensuring compliance of third-party payers; investigating payment discrepancies; entering and maintaining information in databases; and submitting claims to health insurance carriers. OR SUBSTITUTION OF EDUCATION: A Bachelor's degree or successful completion of four (4) years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained at an accredited business or technical school, junior college, college, or university for which high school graduation or the equivalent is the normal prerequisite. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR COMBINATION OF EDUCATION AND EXPERIENCE: An equivalent combination of successfully completed post-high school education and specialized experience, as noted above, that meets the total experience requirements. For GS-5 level, only education in excess of the first 60 semester hours (beyond the second year) of a course of study leading to a Bachelor's degree is creditable toward meeting the combination of education and experience. NOTE: Your experience must be documented in your resume and transcripts are required. You will be rated on the following Competencies as part of the assessment questionnaire for this position: Customer Service (Clerical/Technical)Decision MakingManages and Organizes InformationSelf-ManagementTechnical Competence IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. 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. 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). 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. 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/.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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 VA FCCPAC Orlando 733 13800 Veterans Way Orlando, FL 32814 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]