This position is organizationally located in the Purchased Referred Care (PRC) Branch of the Cass Lake Indian Hospital. The function of the PRC Branch is to manage a Purchased Referred Care Delivery System. The purpose of this position is to provide support and technical assistance to specialists in the provision of PRC to Indian beneficiaries. This position is located in Cass Lake, Minnesota in the Bemidji area.

Duties

Initiates and distributes medical authorizations including both hospitalizations and professional fees after determining patient eligibility for Purchased Referred Care (PRC). Assure adequate funds are set aside for all authorized referrals, emergency call-ins and follow up care referrals. Responsible for keeping up-to-date pending and completed PRC patient files, with documented status of all written and verbal transactions. Maintains denial correspondence files including supporting documentation and insures that reconsideration requests are made available to the appropriate supervisor in a timely manner. Incumbent must have knowledge of computer applications relating to PRC program, including the responsibility for entering and verifying all PRC authorizations, payments, cancellations and supplements.

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: Minimum Qualifications for GS-04: 1 Year of General Experience OR 2 Years of Education above the High School level. General Experience is defined as progressively responsible clerical, office, or other work that indicates ability to acquire the particular knowledge and skills needed to perform the duties of the position to be filled. Minimum Qualifications for GS-05: 1 Year of Specialized Experience equivalent to at least the GS-04 Grade Level OR 4 Years of Education above the High School level. Specialized Experience is defined as experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled. Examples include: Responding to inquiries and requests through telephone, correspondence and personal visits. Experience in funds control techniques and monitoring and accounting for funds allotted. Minimum Qualifications for GS-06: 1 Year of Specialized Experience equivalent to at least the GS-05 Grade Level. Examples include: Assuring funds have been obligated within deadlines, unused obligations are cancelled and re-obligated. Assisting in determining patient eligibility. Maintaining obligation registers regarding funds for inpatient and outpatient services. Minimum Qualifications for GS-07: 1 Year of Specialized Experience equivalent to at least the GS-06 Grade Level. Examples include: Experience in applying policies, procedures, rules and regulations when determining patient eligibility, availability of services and identification of fiscal resources. Managing funds control techniques to account for allotted funds and preparing statements and reports. 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 Cass Lake Service Unit 425 7th Street NW Cass Lake, MN 56633 US
• Name: Robby Chasing Hawk
• Phone: 218-335-3268
• Email: [email protected]