ORGANIZATION LOCATION: Department of Health & Health Human Services (HHS), Indian Health Service (IHS), Southwest Region, Phoenix Area -Resource Management Services- Purchase Referred Care Department, Fort Yuma Service Unit. Position is located in Winterhaven, CA., and Supervised through Supervisory Health System Specialist. Employee identifies and assists patients who may be eligible for coverage by third party resources.

Duties

Receives notification and referrals for non-IHS and IHS referred care through hard copy or the automated referred care system. Enters or edits all referrals. Ensures accurate data entry in order to retrieve meaningful reports. Prepares memoranda for correspondence for the reviewing appeals, identifies deficiencies and recommends appropriate course of action. Performs substantive research in the areas of medical documentation, administrative compliance, inquiries and reports of investigation and standards of conduct/ethics. Reviews completed documents for accurate patient information, clinical data, obligation signatures and fiscal data. Extracts statistical data from various software systems to prepare and submit reports. Answers telephone and personal inquiries regarding payment, patient admitted to non-IHS facilities, outstanding charges, eligibility, etc. Medical confidentiality must be maintained and adhered to.

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-06: 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: Apply an extensive body of rules and procedures concerning benefits sufficient to clarify benefit processes and procedures to patients, conduct personal or telephone interview, search records or guidelines, provide full explanations in response to specific inquiries relating to the agency, resolve problems and issues, evaluate the extent of the customer's knowledge of the options and choices open to them, explain the requirements placed on them by laws and regulations, review records and contact other offices to learn status of pending actions, the reasons for delays or changes, and what action or additional information is required to resolve the case. GS-07: 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: Apply comprehensive rules, regulations, techniques and procedures sufficient to review the particular circumstances and goals of individuals in order to apply the combination of benefits, services or regulatory requirements that will best meet their needs over a span of time; advise individuals on all aspects of benefits and services that should be considered in deciding the most advantageous choice or action; demonstrate alternative formulas for computing benefits with offsetting advantages and disadvantages; compile and write reports and Alternate Resource needs. GS-08: 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: Perform applicable tasks, described in the GS-7, independently, interprets and follow established policies and procedures and in some instances determines appropriate method and approach without consultation with supervisor. 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

There are no education requirements.

Contacts

• Address Fort Yuma Service Unit 401 E. Picacho Road Winterhaven, CA 92283 US
• Name: Phoenix Area IHS Human Resources
• Email: [email protected]