This position is located in the Business Office, Division of Administrative Services at the Crownpoint Healthcare Facility, Crownpoint, NM. The employee is responsible for overseeing the full range of technical services in coding, abstracting, billing, posting and claim collections follow-up functions and have an in-depth knowledge in downloading Electronic Files Transfers (EFT), Electronic Data Interchange (EDI), AR reconciliation and the Unified Financial Management System (UFMS) reports.

Duties

Leads Billing and Accounts Receivable staff engaged in coding, abstracting, billing, posting and collections follow up activities in the Business Office. Distributes and balances the workload among employees in accordance with established work flow or job specialization, assure timely accomplishment of the assigned workload, and assure that each employee has enough work to keep busy. Demonstrate leadership skills in identifying inconsistencies or discrepancies in medical documentation by enforcing compliance regulatory requirements. Provides information on the difference with Medicare, Medicare Supplement, Medicare Advantage, Medicaid, Affordable Care Act (ACA}, Health Insurance Marketplace and Medicaid expansion and Workman's Compensation to employees, patients, etc. in understanding types of coverage, applying for and enrolling in health benefits coverage through the Marketplace. Reviews and ensures that work completed is accurate and procedures, methods and deadlines have been met. Receives and examines alternate resources claims to assure claims are completed with appropriate supporting documents which typically include utilization review certifications. Conducts a thorough review of all abstraction and search of records, guidelines in order to select the most accurate and descriptive codes in accordance with CPT/HCPCS coding system.

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: Preparing and submitting claims to third party payers; assisting in upgrades of automated and electronic billing programs; coordinating benefits, third party billing, verification of data, claims processing and accounts receivable; researching rejected claims; correcting rejected claims with third party payers; searching and retrieving information from an electronic health record to generate indicator of health statistics and status from ICD-CM coding volumes OR 1 year (18 semester hours) of graduate education that is directly related to the work of the position. 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 Crownpoint Healthcare Facility PO Box 358 Crownpoint, NM 87313 US
• Name: Navajo Area IHS Human Resources
• Email: [email protected]