The position is in the Veterans Health Administration (VHA) Office of Finance's Revenue Operations and aligned with a Consolidated Patient Account Center (CPAC). Through the VHA Chief Financial Officer (CFO), VHA's Office of Finance serves in a mission critical role as the principal financial advisor to the Under Secretary for Health (USH).

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-7. At the GS-6 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-7. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher level work, and availability of funds. Performs 1st and 3rd party facility revenue actions by identifying the type of action, verifying guidelines requirements, and obtaining encounter-specific information using multiple automated data delivery systems. Evaluates the revenue specific data and implements the most responsive and cost-effective means of preparing 3rd party revenue data for clean claims processing by the CPAC Billing Department. Verifies the copayment status of actions and specific program requirements for care received to determine whether copayments for care outside the agency and/or retroactive billing of copayments based on income-based exemption determinations are required. Determines the appropriate amount of a copayment charge based on the level of care provided, as well any specific program limitations. Determines whether a release of information (ROI) is needed and how to correctly document ROI for billing purposes and initiates, gathers, and processes 3rd party revenue actions related to legal case activities and applying appropriate and agency guidelines such as revenue polies and procedures. Documents account status updates, transactions, decisions, and other actions for facility revenue billing and payment activities in the system of record. Reviews health care payment accounts (e.g., reimbursement, savings, flexible spending) to verify allowability of billing such accounts. Perform all duties as assigned. Work Schedule: M-F (8am - 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

For GS-06 Specialized Experience: Possess at least one (1) full year of specialized experience, which equips you with the knowledge, skills, and abilities to perform successfully the duties of the (Reimbursable Billing Technician), GS-06 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the grade GS-05 level in Federal service to qualify at the grade GS-06. Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Identifies, reviews, analyzes, process and completes co-payments and insurance encounters and other billing related activities.4)Independently reviews and processes all specialty billing encounters.5) Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, Coordination of Benefits (COB) information and certification requirements for secondary billing. Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, Coordination of Benefits (COB) information and certification requirements for secondary billing. For GS-07 Specialized Experience: Possess at least one (1) full year of specialized experience, which equips you with the knowledge, skills, and abilities to perform successfully the duties of the (Reimbursable Billing Technician), GS-07 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the grade GS-06 level in Federal service to qualify at the grade GS-07. Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Initiates, gathers, and processes 3rd party revenue actions related to legal case activities by applying appropriate and relevant guidelines.4)Researches and recognizes data for dialysis billing to 3rd party insurance companies using a specified patient claims information system database.5) Conducts assigned ad hoc corrective projects, answers questions, and solves agency revenue account problems.6) Assists in synchronizing and the operationalization of all revenue activities.7) Accesses various menu options to identify, review, analyze, process and complete co-payments and insurance encounters and billing related activities. Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, Coordination of Benefits (COB) information and certification requirements for secondary billing. 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

This job does not have an education qualification requirement.

Contacts

• Address VA FCCPAC Orlando 733 13800 Veterans Way Orlando, FL 32814 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]