This position is located at the Whiteriver Indian Hospital, Revenue Department, Whiteriver, Arizona. This position is responsible for completing revalidation and re-enrollment requests from CMS, Arizona Medicaid, and other state Medicaid programs as required. This position ensures account information is maintained and updated for credentialing, insurance, and billing purposes.

Duties

This position is being re-advertised to solicit additional applications. Applicants who applied previously need not reapply unless submitting updated and/or missing information. Serves as the facility or provider authorized organization official to review and complete CMS, state Medicaid, private insurance, and managed care applications. Submits with administrative approval. Manages all aspects of the Provider Enrollment program including developing and coordinating internal review systems to assure that both clinical and administrative activities follow agency, accrediting and regulatory requirements, and Medicare and Medicaid certification. When possible, serves as the authorized official or agent to act on behalf of providers or the service unit to create and manage various accounts in order to register, attest, and submit performance quality measures. Analyzes and evaluates (on a quantitative or qualitative basis) the effectiveness of program operations in meeting established goals and objectives for provider enrollment, reporting requirements and timeliness of organizational responses and performance reporting.

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, GS-0671-09: 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: Examples include: Direct the activities of the Accounts Receivable and/or Denial/Accounts Management functions, perform long and short range planning, evaluation, and analysis; and projection of future resource requirements, personnel administration, provide training, development, and orientation of new and existing employees, and continuous quality improvement; Perform a variety of accounts receivable and denial/accounts management functions such as: examination, verification and maintenance of data involved in processing payments, denials and partial payments from alternate resources; determine the eligibility of patients; Identify and analyze issues, problems and challenges facing the revenue cycle management; Evaluate and compile data of denied claims and analyzes status reports for review to Management. OR; Have completed a master's or equivalent graduate degree that included major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR; I have a combination of education and health system specialist experience, as defined in the vacancy announcement, that when combined, fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-09 grade level. OR; Have completed two full years of progressively higher level graduate education leading to such a degree that included major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. 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 White River Service Unit PO Box 860 White River, AZ 85941 US
• Name: Chelsea Banteah
• Email: [email protected]