This position is located in the Purchased Referred Care (PRC) department at the Claremore Indian Hospital in Claremore, OK. The primary responsibility of this position is to provide support and technical assistance to the PRC department, including medical, surgical, hospital, and clinical services for the hospital. The incumbent will report to the PRC Supervisor.

Duties

Interview patients to verify eligibility and evaluate for possible alternate resource eligibility. Prepare and distribute authorizations, follow up letters, denials, and/or deferred letters to patients and contract medical providers. Coordinate and schedule patient appointments for Purchased Referred Care. Assist with the preparation, submission, and payment processes of purchase orders for services rendered. Provide tactful and professional customer service to patients.

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: Your resume or other supporting documents must demonstrate that you meet at least one of the following minimum qualifications for the grade you are applying for: GS-05: One (1) year of specialized experience equivalent to at least the GS-04 level in the Federal service that has equipped me with the particular knowledge, skills, and abilities to successfully perform the duties of the position. Experience includes: Providing patient registration and eligibility services information; and interacting with patients to obtain and process demographic and insurance information for alternate resources, and private and commercial insurance. OR Four years of education above the high school level. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college, or university. OR A combination of education and specialized experience that, when combined, fully meet the minimum qualifications for this position. Only education in excess of 60 semester hours above the high school level is creditable towards meeting the specialized experience requirement. The total percentage equals at least 100 percent to qualify for this GS-05 grade level. GS-06: One (1) year of specialized experience equivalent to at least the GS-05 level in the Federal service that has equipped me with the particular knowledge, skills, and abilities to successfully perform the duties of the position. Experience includes: Preparing, processing, and issuing medical referrals for outside vendors; communicating with patients regarding bills, status of claims, approved referrals, follow up appointments, and appeal process when necessary within the scope of PRC procedures and policy; and coordinating the management of the health care delivery system by providing contract medical vendors with purchased referred care (PRC) authorizations to determine an estimated cost of the services render, whether inpatient or outpatient services. Typing Proficiency: Applicants must also meet the following proficiency:40 words per minute typing speed based on a five 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

If you qualify based off of your education, 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 Claremore Service Unit 101 S Moore Claremore, OK 74017 US
• Name: Shiron Musick
• Phone: 918-342-6681
• Email: [email protected]