This position is located at the VA Las Vegas Medical Center, in the organization of the Chief Operating Officer, Las Vegas, NV.

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** Duties include but may not be limited to: Responsible for the billing, accounts management, and insurance verification functions. Utilize various databases and reporting tools as well as running multiple reports. Provides expertise for pharmaceutical billing. Review returned/rejected claims for reason for rejection or denial, taking appropriate corrective action and resubmitting claims for payment. Ensure proper follow-up procedures are done through phone calls to the insurance companies, accessing insurance company's online data base and submitting letters to the insurance company. Develop and validate data to successfully resubmit claims to acquire payment. Actively contacts and pursues third-party payers to expedite collections. Assess workload on a daily basis establishing priorities to facilitate the timely and appropriate completion of all assigned tasks. Work Schedule: Fulltime, Monday-Friday, 8:00am - 4:30pm

Requirements

Qualifications

You may qualify for this position based on your experience as noted below: SPECIALIZED EXPERIENCE: Possess at least one (1) year of specialized experience equivalent to the next lower grade level (GS 5) in Federal Service that includes performing the following duties: Ensures claims are submitted in various formats to meet specific requirement of appropriate insurance carriers to improve collections.; Reviews, researches and analyzes account receivable records by utilizing various databases.; Performs analysis on outstanding pharmacy third party receivables to ensure proper debt collections.; Performs claims submission related to prescription drugs provided for beneficiaries.; Provides expertise on claim submission actions to ensure compliance with agency, pharmacy, and insurance standards. Ensures claims are submitted in various formats to meet specific requirement of appropriate insurance carriers to improve collections.; Provides advisory and technical assistance to professional and administrative staff concerning a verity of issues related to the electronic submission of pharmacy claims. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding experience.) You will be rated on the following Competencies as part of the assessment questionnaire for this position: Analytical ThinkingOrganizational Performance AnalysisPrinciples of FinanceTechnical Competence IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. 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). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Physical Requirements: The work is primarily sedentary, although some slight physical effort may be required. Work is performed in an adequately lighted and climate controlled office setting involving everyday risks and/or discomforts which require normal safety precautions typical of such places as various hospital offices. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

There is no educational substitution at this grade level.

Contacts

• Address VA WCPAC Las Vegas 736 1085 Palm Airport DR Las Vegas, NV 89119 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]