This position is located in the Business Office at the Mescalero Service Unit, Mescalero, New Mexico. The primary purpose of this position is the overall responsibility for a full range of technical services in coding, abstracting and billing functions independently. This responsibility includes the submission of properly executed claims on a timely basis to third party payers and responsible parties, and rebilling or corrected billing of accounts previously submitted.

Duties

Receives and examines alternate resources claims to assure claims are complete with appropriate supporting documents which typically include utilization review certifications. Verifies accuracy of health claim numbers, claimed amounts are authorized, and that items or services billed are allowed by appropriate regulations, decisions, directives and other controlling guides. Identifies errors, omissions, duplications in documents and contact the appropriate individuals to resolve problem. Conducts a thorough review of all abstractions and search of records, guidelines in order to select the most accurate and descriptive codes in accordance with the appropriate coding system. Reviews system generated reports daily to identify claims that are ready for billing. Prepares and submits claims to third party payers, intermediaries or responsible parties after all information for billing becomes available from the Coding staff. Establishes patient accounts and documents all activity performed on patient accounts in the patient financial folder such as date billed and to whom.

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 GS-06 level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: submitting claims to third party payers and responsible parties, rebilling or correcting billing of accounts previously submitted. This experience also includes such things as verifying information, reviewing reports to identify claims and using the various types of computer systems. 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 Mescalero Service Unit PO Box 210 Mescalero, NM 88340 US
• Name: Kalerie Stevens
• Phone: 505-256-6827
• Email: [email protected]