This position serves as a Medical Reimbursement Technician within the Business Office performing a broad range of duties to achieve the established Central Office expected results for medical billing, reimbursable/non-reimbursable collections, and insurance verification.

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** Duties will include, but are not limited to the following: Performs verification of patient insurance coverage. Obtains patient insurance information through automated databases, direct patient contacts and contact with insurance companies. Verifies benefits, policy number, pre-certification requirements, and effective dates of coverage. Accepts and completes work provided by a standardized control system such as batched work, caseload level or other defined structure. Responsible for Medicare reimbursable billing activities. Ensures that all billable cases are identified and that bills are accurately generated. Validates claims for billing purposes, ensuring eligibility, and referring questionable coding for review. Follows instructions about timeliness, objectives and relative priorities for doing work. Exercises sound judgment to determine the appropriateness of data and information provided on a claim. Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies.. Use a wide range of office software applications. Follows instructions about timeliness, objectives and relative priorities for doing work. Performs other related duties as required. Work Schedule: Monday-Friday, 8:00am-4:30pm Recruitment & Relocation Incentives: Not authorized Recruitment Incentive: Authorized - $3,000 Recruitment Incentive available for highly qualified applicants with an 18-month service agreement. 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

This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 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-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher level work, and availability of funds. Specialized Experience (GS-5): At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-4) that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician. Specialized experience includes follows instructions about timeliness, objectives, and relative priorities for doing administrative work; communicates with other staff as necessary to discuss administrative concerns; and reviews and determine the appropriateness of administrative data. OR Education: Successfully completed four (4) years of education above the high school level in any field which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation. OR Combination: Equivalent combinations of successfully completed post-high school education (beyond the second year) and specialized experience, as described above, which meet the total experience requirements for this grade level. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation. Specialized Experience: (GS-6) At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-5) that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician. Specialized experience includes: follows instructions about timeliness, objectives and relative priorities for doing administrative work; communicates with other staff as necessary to discuss administrative concerns; and reviews and determines the appropriateness of administrative data; validates claims for billing purposes ensuring eligibility and referring questionable coding for review; and Interprets insurance policies and requirements for billing. You will be rated on the following Competencies as part of the assessment questionnaire for this position: Customer Service (Clerical/Technical)Decision MakingManages and Organizes InformationSelf-ManagementTechnical Competence IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. 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. Physical Requirements: Position is sedentary, may require some physical effort such as, periods of standing, walking, or bending. There are no special physical demands 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

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

There is no educational substitution for experience at the grade 6.

NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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: Recognition of Foreign Qualifications | International Affairs Office (ed.gov).

Contacts

• Address VA NCCPAC Madison 8001 Terrace Ave Middleton, WI 53562 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]