This position provides clerical support, and technical assistance to the Purchased Referred Care department (PRC) for the Lawton Indian Hospital. The incumbent is responsible for following the delivery of Purchased Referred Care from the initial patient and/or vendor request through the final billing by the vendors and processing all related paperwork. Reports to the Supervisory Health System Specialist for the PRC Department.

Duties

Verifies patient's eligibility for Purchased/Referred Care by reviewing documentation in the patient registration regarding eligibility and alternate resources availability for services rendered (i.e. medical, surgical, hospital, and clinical services). Prepare and distribute all authorizations, follow up letters on outstanding purchases, issuance of purchase orders, and denial and/or deferred letters. Assist in the preparation, submission, and payment processes of purchase orders for services rendered. Identify and submit Catastrophic Health Emergency Fund (CHEF) cases for reimbursement. Monitors and reports status of PRC funds available and prepares analytical data and reports that reflect utilization of resources.

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. BASIC REQUIREMENT(S): Applicants must meet the following typing proficiency: 40 words per minute based on a five minute sample with three or fewer errors. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: 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: For GS-5: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-4 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining medical eligibility requirements and obtaining and processing demographic and insurance information for patient registration, alternate resources, purchase referred care services, or related purposes. OR You must have successfully completed 4 years of education beyond the high school level. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. Four years of full-time academic study is defined as 120 semester hours, 180 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 144 weeks in a business, secretarial, or technical school (must provide transcripts). OR Equivalent combination of successfully completed post-high school education and experience are also qualifying. Determine your total qualifying experience as a percentage of the 1 year of experience required for GS-5; then determine your education as a percentage of the 4 years of education that meets the requirements for GS-5. Add the two percentages. The total percentage must equal at least 100 percent to qualify. For GS-6: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-5 grade level in the Federal service obtained in either the private or public sector performing the following types of work and/or tasks: patient referred/care procedures and regulations, working with funding limitations and policies, technical, administrative and clerical functions related to the patient referral program, case reporting and assist in close out of cases, proper processing requirements including forms, authorization documents. 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

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 Lawton Service Unit 1515 North Lawrie Tatum Rd Lawton, OK 73507 US
• Name: Napua Gonzalez Aponte
• Phone: 580-354-5106
• Email: [email protected]