About the Position: This position reviews and processes medical claims for Tripler Army Medical Center, Hawaii.

Duties

Refer to legal and medical professionals to develop information pertinent to claim. Maintain all reports and records to monitor all processed medical claims recovery actions. Process claims using automated database . Prepare reports to keep track of assigned cases or maintain a suspense system. Use liability or legal terminology to process medical claims. Answer patient questions to advise on medical claims. Utilize automated systems to prepare correspondence.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• One Year probationary period may be required.

Qualifications

Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. Current Civilian Employees of the Defense Health Agency (DHA)Current Permanent Department of Defense (DoD) Civilian EmployeeDomestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel WorkforceInteragency Career Transition Assistance PlanLand Management Workforce Flexibility ActMilitary Spouses, under Executive Order (E.O.) 13473Non-Appropriated Fund Instrumentality (NAFI)Non-Department of Defense (DoD) TransferPriority Placement Program, DoD Military Spouse Preference (MSP) EligibleReinstatementVeterans Employment Opportunity Act (VEOA) of 1998 In order to qualify, you must meet the specialized 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. GS-06 Qualification: Specialized Experience: One year of specialized experience which includes reviewing legal documents for accuracy AND applying legal policies. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). GS-07 Qualification: Specialized Experience: One year of specialized experience which includes 1) examining medical statements and documentation AND 2) advising personnel or customers on requirements for medical claims processes. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted. You will be evaluated on the basis of your level of competency in the following areas: CommunicationsCustomer Service (Clerical/Technical)Office OperationsPatient-focused Customer Service Time in Grade Requirement for GS-06: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-05). Time in Grade Requirement for GS-07: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06).

Education

Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.

Contacts

• Address JT-DHA-DD83DF DHA INDO PACIFIC MARKET DO NOT MAIL APO, AP 96224 US
• Name: Army Applicant Help Desk