This position is located at the Hopi Health Care Center, Polacca, Arizona. The purpose of this position is to provide medical program technical assistance to the Purchased Referred Care (PRC) program. Incumbent will carry out a complete and accurate control system for a program which manages the contractual aspects of medical and hospital services for the qualified American Indian (AI) and Alaskan Native (AN) population within the Hopi Health Care Center service unit.

Duties

Initiate medical authorizations to include hospitalizations and medical fees for qualified American Indians. Authorization documents are reviewed for patient demographic information, clinical data, obligation signatures, certification signatures and fiscal data. Monitors activities and records pertaining to the fiscal management of Purchased Referred Care (PRC). Identifies problem areas and recommends corrective action. Reconciles and balances the commitment registers with CHS/MIS, Fiscal Intermediary (FI) and United Financial Management Services (UFMS). Ensures and maintains internal fiscal controls: and billing procedures on funds being obligated. Reports are submitted to the PRC Health System Specialist for review and signature. Maintains control of and makes appointment arrangements for outpatient health care services subject to the regulations regarding purchases, fully utilization of Electronic Health Record and the limitation of funds authorized. Prepares authorization and schedules admissions in non-I.H.S. facilities as funds become available. Maintains files regarding the Purchased and Referred Care program, which includes letter of denials with all backup materials for reason for denial, etc. Answers telephone and personal inquiries regarding payment, patients admitted to other than I.H.S. facilities, outstanding charges, eligibility, etc. Medical confidentiality must be maintained. Answers technical correspondence and compiles information and prepares for submission of periodic and special reports concerning PRC data to the Area Office and Service Unit Director.

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 (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Apply patient referred/care procedures and regulations; work with funding limitations and policies, technical, administrative and clerical functions related to the patient referral program; properly process forms, authorization documents, correspondence and reports based on requirements; and maintain records regarding funds for medical services. MINIMUM QUALIFICATIONS, GS-07:Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Apply policies, procedures, rules and regulations when determining patient eligibility, availability of services and identification of fiscal resources; manage fund control techniques to accounts for allotted funds and preparing statements and reports; and operate an automated data program system for patient referral reports, and controlling of funds. In addition to meeting the Minimum Qualifications, you must meet the Typing Proficiency Requirement below. TYPING PROFICIENCY REQUIREMENT: In addition to meeting the experience requirements, applicants for these positions must show possession of the following typing skill. Applicants may meet these requirements by passing the appropriate performance test, presenting a certificate of proficiency from a school or other organization authorized to issue such certificates by the Office of Personnel Management local office, or by self-certifying their proficiency. Performance test results and certificates of proficiency are acceptable for 3 years. Agencies may verify proficiency skills of self-certified applicants by administering the appropriate performance test. Must be able to type at least 40 words per minute based on a 5-minute sample with three or fewer errors. 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

There are no education requirements.

Contacts

• Address HOPI HEALTH CARE CENTER PO Box 4000 Polacca, AZ 86042 US
• Name: Chelsea Banteah
• Email: [email protected]