This position will support the Federal Government's response efforts to COVID-19. THIS POSITION IS BEING RE-ADVERTISED TO SOLICIT ADDITIONAL APPLICATIONS. APPLICANTS WHO APPLIED PREVIOUSLY NEED NOT REAPPLY UNLESS SUBMITTING UPDATED AND/OR MISSING INFORMATION.

Duties

The position is located at the New Sunrise Regional Treatment Center (NSRTC), located on the Pueblo of Acoma, Acomita, NM and reports to the Chief Executive Officer. The incumbent manages, evaluates and analyzes the Business Office functions that include: the third-party resource billing and collection processes, credentialing and privileging of psychologist, Medicaid enrollment, patient registration, and receiving agent duties for NSRTC. Provides direction and supervises staff of the Business Office; in conjunction with his/her supervisor, develops an affirmative action plan for the functional area supervised including appropriate objectives and goals, and monitors and periodically assesses progress. Establishes and maintains a working relationship with third party payers and IHS employees responsible for Area collections; leads in the creation, implementation and maintenance of Business Office policies and procedures and assures compliance with all applicable laws and regulations. Monitors productivity of all Business Office components to ensure optimum cost-effectiveness and efficiency; conducts quality assurance reviews of the billing office functions; supervises and assists in the timely and accurate submission of claims to third party payers, according to AAIHS policies and procedures. Maintains Medicaid and private commercial insurance manuals, circulars and directives, transmittals of bills, vouchers and schedules and any addendum to the ICD-10-CM Coding volumes; reviews all rejected/pending claims to determine reason(s) for rejections/pending status and delegates back to biller for correction and resubmission; actively performs audits and reviews to ensure documentation and accountability of all health insurance claims submitted for payment by conducting random sample reviews. Implements credentialing/privileging policies and procedures and maintains all credentialing/privileging files in a secure manner; represents NSRTC in all AAIHS credentialing training and workshops, as well as credentialing reviews; performs receiving agent duties for all property, equipment, supplies, services acquired.

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. For positions requiring positive education requirements, or if you are using education to meet all or part of the qualification requirements, you MUST submit a copy of your transcripts or an itemized list of college courses which includes equivalent information from the transcript (course title, semester/quarter hours, and grade/degree earned) in your resume. BASIC REQUIREMENT(S): 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 the GS-07 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks as described below OR amaster's or equivalent graduate degree OR 2 full years of progressively higher-level graduate education leading to such a degree OR LL.B. or J.D., if related. Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. Special Provision for Inservice Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: -Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. 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 New Sunrise Regional Treatment Center PO Box 219 San Fidel, NM 87049 US
• Name: Carolyn Chavez
• Phone: (505) 256-6824
• Email: [email protected]