One permanent full-time position as the Medical Support Assistant (OA) to be filled in the Purchased/Referred Care (PRC) Department at the Whiteriver Service Unit in Whiteriver, Arizona. The Incumbent will provide support and technical assistance to the other PRC assistants and program supervisor. Incumbent will assist in determining patient eligibility for care under the PRC program and Direct Supervision will be the PRC Supervisor.

Duties

Assists in determining patient eligibility for care under the PRC Program. Defines alternate resources available to patients under the PRC Program and determines patient eligibility for Medicare, Medicaid, Vocational rehabilitation, V.A., private insurance, etc. Makes patient transportation arrangements subject to regulations regarding purchases and the limitation of authorized funds for Native Air flights and other third parties. Administers day-to-day activities required of the PRC Program by initiating PRC medical purchase orders. Ensures consistency and correct use of document coding required by Area financial management policy. Maintains PRC automated commitment registers in the RPMS to ensure the accurate accountability of funds and proper fiscal coding procedures. Maintains denial correspondence files including supporting documentation and ensures that reconsideration requests are made available to the appropriate supervisor in a timely manner. Maintains denial correspondence flies including supporting documentation and ensures that reconsideration requests are made available to the appropriate supervisor in a timely manner, Ensures the F1 "pends" for service unit action are resolved in a timely manner. Maintains monthly and special reports including PRC Managed Care Patient Status Report to the PRC Committee and work with the IHS fiscal intermediary to resolve payment problems and coordinate 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-06: Your resume must demonstrate at least one year of specialized experience at or equivalent to GS-5 grade level in the Federal service obtained in either the private or public sector performing the following tasks: reviews incoming health care correspondence to determine appropriate action; requests additional medical information; and review claims for obligation or denial. The combination of education and experience that, when fully combined, meet the minimum qualifications for the position. Typing Proficiency In addition to meeting experience or education requirements, applicants for this position must show possession of the following skills, as appropriate. Typing Proficiency; Applicants may meet the requirements by passing the appropriate performance test and presenting a certificate of proficiency from a school or other organization authorized to issue such certificates. Performance test results and certificates of proficiency are acceptable for 3 years. 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 the closing date of the announcement.

Education

There are no education requirements.

Contacts

• Address White River Service Unit PO Box 860 White River, AZ 85941 US
• Name: Debbie Standing
• Phone: (928) 338-3561
• Email: [email protected]