This position is located at the Great Plains Area Youth Regional Treatment Center, Wakpala, SD, five (5) miles northwest of Mobridge, SD. The primary purpose of this position is to abstract and interpret data from medical records for preparation and submission of third- p a rt y claims, maintain the medical records, and provide clerical and/or administrative support to YRTC management. Incumbent also assists with the records management responsibility for the facility.

Duties

Responds to third party requirements on post payment reviews, exclusions, denials, and appeals. Actively performs audits and medical record reviews to ensure documentation and accountability on all health insurance claims submitted for reimbursement by conducting random sample review Verifies that medical records contain proper documentation in accordance with regulations, including proper diagnoses, original signature(s), accurate dates of services, and that care providers are in compliance with attestation and billing requirements. Enters new patients into electronic health record. Maintains a current verification system on each patient receiving care from this facility. This consists of contacting various Federal, State, and County agencies to verify current eligibility for third party health insurance and their identifying numbers. Notifies the insurance carrier within the time frames required. Enters all required information into EHR (electronic health record) Communicates with DHHS personnel: Fiscal Intermediary Administration and Claims Processing personnel; Social Security Administration; Department of Social Services; PRO Personnel; and GPAYRTC personnel to identify and correct problems with application and operation systems. Provides follows-up on suggested method(s} implementation/corrections. Assists with milieu coverage, answering the telephone and provides various reports to Administration while maintaining consistent documentation for monthly report/quarterly/yearly reports

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): Medical Support Assistance Series 0679 (opm.gov) 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: GS-6: 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-06 level in the Federal service as described in the vacancy announcement. Examples include: Experience working with a variety of correspondence in proper formats using word processing programs, office automation, data collection, and tracking information; experience creating manual and electronic calendars; serves as the point-of-contact for an office and refers issues to the supervisor; performing data entry into an automated timekeeping, travel systems and ordering supplies. 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

There are no education requirements.

Contacts

• Address Great Plains Regional Treatment Center 12451 Hwy 1806 Mobridge, SD 57601 US
• Name: Joseph Dudley
• Phone: 605-226-7203
• Email: [email protected]