This position is in the Veterans Health Administration (VHA) Office of Finance's Revenue Operations and aligned with a Consolidated Patient Account Center (CPAC) and is located in Durham, NC.

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS 7. At the GS 6 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS 7. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. Duties include but may not be limited to: Works with others to solve revenue problems. Determines whether a release of information (ROI) is needed and how to correctly document ROIs for billing purposes. Preforms daily reviews, audits, and/or corrective actions in response to workload. Documents account status updates, transactions, decisions and other actions for facility revenue billing and payment activities. Processes internal actions to overturn claim denials proactively or reactively from insurance carriers. Reviews outpatient encounters, inpatient admissions and discharges, long-term care visits, workers' compensation data/information and specialty (i.e., not in conformance with standard billing requirements) encounters to gain requisite data necessary for 3rd party billing preparation. Prepares specialty-specific 3rd party billing transactions. Work Schedule: Fulltime, Monday-Friday, 8:00am - 4:30pm

Requirements

Qualifications

QUALIFICATIONS To apply for this position, you must have the following qualifications: SPECIALIZED EXPERIENCE: For the GS 6 position you must possess 1 (one) year of specialized experience equivalent to at least next lower grade level (GS 5). Specialized experience includes but is not limited to: Assigns disposition instructions and implements the most responsive and cost-effective means for managing them.; Accesses, retrieves, manages, and processes various revenue reports.; Assists in synchronizing and the operationalization of all revenue activities.; Reviews and processes specialty billing encounters to determine the appropriate action to be taken.; Communicates with a diverse customer base. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding experience.) For the GS 7 position you must possess 1 (one) year of specialized experience equivalent to at least next lower grade level (GS 6). Specialized experience includes but is not limited to: Assigns disposition instructions and implements the most responsive and cost-effective means for managing them.; Accesses, retrieves, manages, and processes various revenue reports.; Assists in synchronizing and the operationalization of all revenue activities.; Reviews and processes specialty billing encounters to determine the appropriate action to be taken.; Initiates, gathers and processes 3rd party revenue actions rela­ted to legal case activities by applying appropriate and relevant guidelines.; Applies analytical and evaluation techniques to determine if co-payment bills are appropriate.; Prepares specialty-specific 3rd party billing transactions, which are more complex and require research, preparation and problem solving beyond traditional 3rd party billing actions.; Determines the best course of action for both external and internal customer co-payments, insurance and pharmacy billing and other benefit-related activities involving the use of many different methods and resources.; Provides sufficient information to determine the required or most appropriate actions to take or opt in to benefits or privileges, afforded to patients under Federal law and/or Regulations. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions You will be rated on the following Competencies as part of the assessment questionnaire for this position: Customer Service (Clerical/Technical)InsuranceOrganizational AwarenessTechnical 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 primarily is sedentary, although some slight physical effort may be required. Some work may require walking, carrying light supplies/work records, utilizing telephone, fax, computer, copier and other standard office equipment. Occasional travel for training or attendance at national meetings is also required. 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 MACPAC Asheville 730 128 Bingham Rd. Suite #500 Asheville, NC 28806 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]