This position is located in SRSU, Division of Admin Services, Business Office Branch. Purpose of this position is the overall responsibility for a major segment of the accounts receivable management function. This responsibility includes the submission of properly executed claims on a timely basis to third payers and responsible parties and bebilling or corrected billing of accounts previously submitted. Incumbent reports to the Supervisory Health System Specialist.

Duties

Responsible for the accurate and timely preparation and submission of claims to third party payer, intermediaries, and responsible parties according to established hospital policy and procedures. Responsible for maintenance and control of unbilled claims for an assigned section of patient receivables. Responsible for verification that all control functions assigned are maintained daily as set forth in hospital policy and procedures. Reviews system generated reports daily to identify claims that are ready for billing. Prepare and submit claims to third party payers, intermediaries or responsible parties within 24 hours after all information for billing becomes available. Responsible for the error correction for all rejected/suspended claims previously submitted to third party payers and intermediaries and patients according to hospital policy and procedures.

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 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: GS-05: One (1) year of specialized experience at the GS-4 level and/or 4 years above high school; or a combination of both specialized experience and education. Specialized Experience: candidates must demonstrate ability to bill for a health care center where incumbent is expected to collect and enter claim information, post insurance and patients and manage accounts, submit claims and following up with insurance carriers on unpaid or rejected claims, answer patient inquires on account status and charges. Examples of work that demonstrates this ability include: compile account statements, compute balances and record billing payments for any company. Responsible for preparing invoices for services rendered or for the delivery of goods. Calculate interest, penalties and late fees for clients who are past due on their accounts. Work daily with both paper forms and specialized computer programs when inputting and analyzing account information. GS-06: One (1) year of specialized experience at the GS-05 level. Specialized Experience: candidates must be knowledgeable on insurance and reimbursement process to collect and enter claim information, post insurance and patients and manage accounts, submit claims and following up with insurance carriers on unpaid or rejected claims, answer patient inquires on account status and charges. Examples of work that demonstrates this knowledge include: analyzing billing operations for third party (health care) programs; acting as an advocate in the collection of alternate resources (insurance, Medicaid etc.); assuring collections, billed data and computerized and manual reports are in balance; and ensuring accountability of health insurance claims submitted for payment. 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 Shiprock Service Unit Hwy 491 N PO Box 160 Shiprock, NM 87420 US
• Name: Navajo Area IHS Human Resources
• Email: [email protected]