This position is located in the Business Office at the Warm Springs Service Unit in Warm Springs, Oregon. Work is to process billing claims to third party carriers, which include Medicare Part D, Medicaid and Private Insurance. This position reports to the Business Office Manager. If selected, the GS-05 candidate gains experience toward the full performance level of GS-07 once qualifications requirements met. Recruitment or relocation incentives may be authorized.

Duties

The position is located in an Ambulatory health care center located on the Confederated Tribes of Warm Springs reservation. For more information on the Warm Springs Health and Wellness Center, visit the Indian Health Service Website. If incumbent is hired at the GS-05 level, the selected candidate gains experience toward the full performance level of the GS-07 to perform the duties: Prepares and submits claims to third party payers, intermediaries, and responsible parties. Maintains records and files in accordance with applicable regulations and guidance. Reviews system generated reports daily to identify claims that are ready for billing. Documents to the insurance companies when requested for an audit. Checks for errors and makes correction for all rejected/suspended claims previously submitted to third party payers and intermediaries and patients. Prepares end of month and quarterly status reports which includes amounts billed, collected and outstanding. Researches and follows-up on rejected claims on-line.

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-05 Your resume must demonstrate at least one (1) year of specialized experience equivalent comparable in difficulty and responsibility to the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Compile account statements, compute balances and record billing payments for any company. Responsible for preparing invoices for services rendered or for the delivery of goods. Calculate interest, penalties and late fees for clients who are past due on their accounts. Work daily with both paper forms and specialized computer programs when inputting and analyzing account information; OR, 4 years of education above the high school level. OR, possess a combination of education and experience that when combined fully meet the minimum qualifications for the GS-05 grade level. (Only education in excess of the first 60 semester hours is creditable toward meeting the specialized experience requirement). The total percentage must equal at least 100 percent to qualify an applicant for GS-05 grade level. MINIMUM QUALIFICATIONS: Grade GS-06 Your resume must demonstrate at least one (1) year of specialized experience specialized experience comparable in difficulty and responsibility to the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Analyzing billing operations for third party (health care) programs; acting as an advocate in the collection of alternate resources (insurance, Medicaid etc.); assuring collections, billed data and computerized and manual reports are in balance; and ensuring accountability of health insurance claims submitted for payment. MINIMUM QUALIFICATIONS: Grade GS-07 Your resume must demonstrate at least one (1) year of specialized experience specialized experience comparable in difficulty and responsibility to the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: submit claims to third party payers and responsible parties, rebill or correct billing of accounts previously submitted; verify information, review reports to identify claims and use the various types of computer systems; searches and retrieves individual patient records to gather and compile information for outpatient services. Specialized Experience. Experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled. You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

Successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5 for all positions except Reporting Stenographer, GS-5. 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.

As a general rule, education is not creditable above GS-5 for most positions covered by this standard; however, graduate education may be credited in those few instances where the graduate education is directly related to the work of the position.

Contacts

• Address Warm Springs Service Unit PO BOX 1209 Warm Springs, OR 97761 US
• Name: Margaret Witt
• Phone: (503) 414-7732
• Email: [email protected]