This position is located at the Hopi Health Care Center, located in Polacca, Arizona. The purpose of the position is to ensure timely management of authorizing documents, accurate and courteous patient in-take and out-take and complete and accurate control system of a program which manages the contractual aspects of medical and hospital services for the qualified population eligible for radiology imaging services.

Duties

Initiates/completes prior authorizations for all higher-level radiology imaging for qualified patients independently. Authorization documents are reviewed for patient information, clinical data, obligation signatures, certification signature and fiscal data. Functions in a liaison capacity to both vendors and recipients of contract services by telephone and through written correspondence. Conducts on-site patient interviews to establish qualification of patients for contract services. Completes and maintains applications for medical care. Maintains files of prior authorizations and schedules radiology appointments in the correct modality as funds become available. Maintains, key entrees, updates and verifies all data necessary for patient registration and for accurate billing through the use of the automated patient registration system. Maintains files regarding the contract services 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 the facility, outstanding charges, eligibility, etc. Answers technical correspondence and compiles information and prepares for submission of periodic and special reports.

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-5: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Obtain and process demographic information for patient registration; process and issue medical referrals for outside vendors; provide clerical duties such as making appointments, data entry, maintaining files, and answering phone calls. OR Education: Successfully completed 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. Transcripts must be submitted with application OR Combination of education and specialized experience: Equivalent combinations of successfully completed post high school education and experience may be used to meet total experience requirements. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. Only education in excess of the first 60 semester hours (i.e. beyond the second year) is creditable toward meeting the specialized experience requirement. One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience. Transcripts must be submitted with application. GS-6: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Obtain and process demographic information for patient registration; process and issue medical referrals for outside vendors; provide clerical duties such as making appointments, data entry, maintaining files, and answering phone calls; communicate with patients regarding medical bills, claim status, and referrals; coordinate management of the healthcare delivery system by providing vendors with purchase authorizations to determine estimated cost of services rendered. GS-7: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Obtain and process demographic information for patient registration; initiate and complete prior authorizations for all higher level radiology imaging for qualified patients independently; Technical correspondence and compiling of information to prepare and submit periodic and special reports. Typing Proficiency: Must meet typing proficiency by passing the appropriate performance test, presenting a certificate of proficiency from a school or other organization authorized to issue such certificates or by self-certifying proficiency. 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

This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.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 https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

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