This position is located in a Consolidated Patient Account Center (CPAC) in the organization of the Office of the Director, serving as the Financial Management Specialist (Denials). The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidated of functions and integration of VHA and industry best practices.

Duties

Performs analysis of data from hard-copy Explanation of Benefits or Electronic Explanation of benefits to identify whether a claim was denied for payment and/or adjustments made by the payer. Identifies systemic cause for major denial categories and develop plans/recommendation to effectively address the management of claim denials. Ensures that the re-submission of denied claims is conducted in accordance with established laws, rules, regulations and policies. Provides guidance and assistance in monitoring activities designed to ensure the integrity and accuracy of changes for healthcare services, equipment, and/or medications. Establishes and maintains effective working relations with others throughout the organization. Work Schedule: Monday - Friday, 8:00am - 4:30pm Virtual: This is not a virtual position. Position Description/PD#: Financial Management Specialist/PD018510 Telework: Eligible Yes - as determined by the agency policy. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/24/2023. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-11 position you must have served 52 weeks at the GS-09. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below: GS-11 Specialized Experience: Do you possess at least one (1) full year of specialized experience, which equips you with the particular knowledge, skills, and abilities to perform successfully the duties of the Financial Management Specialist, GS-11 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the GS-09 level in Federal service to qualify at the GS-11. Examples of specialized experience include: 1) Prepares a variety of written products such as complex reports, memoranda, program recommendations, reprogramming justifications, etc. 2) Gathers, analyses, and evaluates a wide range of data from various sources. 3) Performs Analysis of data from hard-copy Explanation of Benefits (EOB) or Electronic Explanation of Benefits (EEOB). 4) Presents highly complex data and information to various audiences. 5) Develops and/or recommends plans to effectively address the management of claims denials. 6) Identifies trends, patterns and corollary activities that may affect claims denials. 7) Provides the customer with consistent information according to established policies and procedures. Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one full year of Specialized Experience at or comparable to the required grade level. OR GS-11: Substitution of Education for Experience (TRANSCRIPTS REQUIRED): Do you possess a PhD. or 3 full years of progressively higher level graduate education leading to such a degree or LL.M., if related? Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. OR GS-11: Combination of Education and Experience (TRANSCRIPTS REQUIRED): Do you possess combinations of successfully completed graduate education and specialized experience directly related to the work of the Financial Management Specialist position, which may be used to meet the experience requirements for GS-11 position? You will be rated on the following Competencies for this position: Analytical ReasoningCommunicationCritical ThinkingTechnical Competence 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; religions; 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. Note: A full year of work is considered to be 35-40 hours of work per week. 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. Physical Requirements: The work is primarily sedentary, although some slight physical effort may be 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

A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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 VA CPCPAC Leavenworth 735 4101 S 4thSt., Trafficway Leavenworth, KS 66048 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]