The Medical Reimbursement Technician position is located at the Mid-Atlantic Consolidated Patient Account Center (CPAC), Chief Operating Officer (COO), Billing and Insurance Verification Department, in Ashville, NC. The Medical Reimbursement Technician performs a broad range of duties to achieve the established Central Office NISN expected results for medical billing and reimbursable and non-reimbursable collections.

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-6. At the GS-5 grade level, the individual performs assignments of a more limited scope and with less independence. The individual will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. Promotion is not guaranteed, and no promise of promotion is implied. These duties can include, but are not limited to: Performs verification of patient insurance coverage. Obtains patient insurance information through automated databases, direct patient contact and contact with insurance companies. Verifies benefits, policy number, pre-certification requirements, and effective dates of coverage. Researches and resolves problems and posts payments, adjustments, denial codes and non-payment collections. Performs follow-up on explanation of benefits received from third party carters to maximize revenue and reviews payments to ensure consistency with insurance policy terms. Updates and maintains patient information in an electronic database. Generates monthly reports as required. Ensures that all billable cases are identified and that bills are accurately generated. Validates claims for billing purposes ensuring eligibility and referring questionable coding for review; monitors reports to assure all possible billable cases are processed. Ensures proper sequencing of diagnostic and procedural codes and assigns modifiers as needed. Tracks, reviews, and corrects denials. Obtains required information and coordinates completion of forms with patients, staff and providers. Responds to patients' questions, explaining eligibility requirements, insurance provisions, and billing and payment procedures. Performs third party collection from insurance companies and accounts receivable functions. Verifies the accuracy of payments, resolves problems and discrepancies, and closes out accounts. Perform other related duties as assigned. Work Schedule: Monday - Friday; 8am to 4:30pm Recruitment & Relocation Incentives: Not authorized Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Financial Disclosure Report: Not Required

Requirements

Qualifications

Specialized Experience GS-5: One (1) year of specialized experience equipped with the knowledge, skills, and abilities to successfully perform the duties of the Medical Reimbursement Technician position. To be creditable for the GS-05 the experience must have been equivalent to the GS-04 in Federal service. Examples of experience include: working knowledge of accounting and collection functions; having knowledge of coding utilizing the International Statistical Classification of Diseases and Related Health Problems (ICD-9), Current Procedural Terminology (CPT) and the Health Care Common Procedural Coding System (HCPCS), to ensure accurate billing; knowledge of eligibility, income screening; working experience in a medical billing environment of healthcare reimbursement and accounts receivables; collecting from third party insurance companies; tracking, reviewing and correcting denials; assuring accurate billing and timely payments; determining eligibility; verifying insurance coverage; and utilizing a personal computer for coding, reports and verifying claim information. OR Substitution of Education for Experience GS-5: Four (4) years of successfully completed 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. (Transcripts Required) OR Combination of Education and Experience GS-5: Equivalent combinations of successfully completed post high school education and experience may be used to meet total experience requirement at the GS-05 level. (Transcripts Required) You will be rated on the following Competencies as part of the assessment questionnaire for this position: Customer Service (Clerical/Technical)Decision MakingManages and Organizes InformationSelf-ManagementTechnical 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 may require some physical effort such as, periods of standing, walking, or bending. There are no special physical demands. 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

IMPORTANT: 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: Recognition of Foreign Qualifications | International Affairs Office (ed.gov).

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]