This position is located in the Administrative Services, Business Office Branch at Dzilth-Na-O-Dith-Hle Health Center, Bloomfield, New Mexico. The primary purpose of this position is to perform dual functions in accordance to Patient Registration duties and Patient Benefits Coordinator duties by identifying patients with eligibility for alternate resources, and updating pertinent demographic information. Incumbent reports directly to Supervisory Health System Specialist.

Duties

Obtain and process confidential information Obtain third party coverage for Alternate Resource, Purchased Referred Care (PRC), and billing purposes. Assist patients with enrollment processes key-entered into facility database. Interviews patients, key-enters into database complete and accurate pertinent patient demographic information to initiate a new health record and re-activate a retired or archived health record from the Federal Record Center (FRC). Assist and explains to patients the importance of gathering information for the permanent health records, by completing new or updated standard forms and interpreting the purpose of why we ask direct questions. Determines and established eligibility for patients seeking health care by verifying alternate resource. Incumbent works closely with Social Security Administration Office (local and regional), Tribal Offices, Community, Department of Welfare or Human Resources, Department of Social Services, State Medical Assistance Office and other appropriate agencies. Identifies and verifies for patients their 3rd party coverage by utilizing the electronic eligibility portals or telephone calls. Provides information on rights and benefits of resources and tactfully advises patients of non-payment or denial of claims. Follow up on all pending applications and works closely with families and agencies to see that patient is not discriminated against because they are IHS recipients. Assists and initiates applications for alternate 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. MINIMUM QUALIFICATIONS: GS-05 Grade level: 1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-04 level in the Federal service as described in the vacancy announcement. Examples include: interviews, assist and explains to patients what specific information is required while ensuring information is complete and accurate; verify patient eligibility for benefits, e.g., dependent or active identification card, date of birth, certificate of service, etc.; apply standardized rules, processes and Procedures concerning claims processing; basic arithmetic sufficient to review claims and correct amounts of allowable items. or 4 years of education above the high school level. NOTE: One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. or combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage must equal at least 100 percent to qualify an applicant for GS-05 grade level. GS-06 Grade Level: 1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-05 level in the Federal service as described in the vacancy announcement. Examples include: interview patients or their representatives to identify problems relating to care; explain policies, procedures, or services to patients using medical Or administrative knowledge; and/or refer patients to appropriate health care services. 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 Dzilth-Na-O-Dith-Hle Health Center 6 Road 7586 Bloomfield, NM 87413 US
• Name: Navajo Area IHS Human Resources
• Email: [email protected]