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Duties

As a Health Insurance Specialist you will: Supervise and manage the member services team responsible for the management of the diagnostic and treatment benefits of a federal health plan and complex program deliverables through analysis and review of problems, issues, or program requirements. Conduct clinical research. Monitor government and industry for information on current and correct code assignments. Develop reports or presentations and manage special cross-cutting initiatives and task force groups. Manage medical claims data, categorize diagnosis and treatment codes and manage the codebook based on standard coding conventions and federal health plans.

Requirements

Qualifications

All qualification requirements must be met by the closing date of the announcement. Minimum Qualifications: To qualify at the GS-14 grade level, you must have at least one year of specialized experience at or equivalent to the GS-13 grade level, which must include the following experience: overseeing the operational requirements of health insurance programs and interpreting program requirements such as diagnostic and treatment benefits of a federal health plan; and collaborating and negotiating on policy development, implementation and/or data analysis with internal and external stakeholders. 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.

Education

Copy of your transcripts or equivalent documentation is required for positions with an education requirement, or if you are qualifying based on education or a combination of education and experience. An official transcript will be required if you are selected.

College or university degree generally must be from an accredited (or pre-accredited) college or university recognized by the U.S. Department of Education. For a list of schools which meet these criteria, please refer to Department of Education Accreditation page.

FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying. For more information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address NIOSH-WORLD TRADE CENTER HEALTH PROGRAM-OFFICE OF THE DIRECTOR 1600 Clifton Road, N.E. Atlanta, GA 30333 US
• Name: CDC HELPDESK
• Phone: (770) 488-1725
• Email: [email protected]