This position is located in the Business Office Branch at the Gallup Indian Medical Center in Gallup, NM. The primary purpose of this position is to serve as the Third Party Liability Coordinator providing coordination and serves as a resource person for third party reporting, correspondences, records retention and archiving within a hybrid (paper/electronic) environment.

Duties

Manages and coordinates all the third-party activities by screening all third-party cases for possible tort liability and reporting any such cases to the Office of Regional Counsel. Processed and reviews Resource Patient Management System (RPMS) reports and any correspondences from Contract Health, Health Information Management (HIM-Medical Records), Patient Registration/Admissions and the Business Office Researches medical records for outside clinical summaries, reviews date of service visits, verifies 3rd Party Coverages and payments received and adds this information into the FMCRA Portal-Business Office. Performs a thorough review of billing record(s) requested from the attorney's or legal entities and insurance carriers. Ensures that all patient documents have patient identification on each page, year activity stamp/sticker, documents and forms in chart sequential order, master control log updated, and chart is clearly identified as combined and complete. Maintains and coordinates the archiving of clinical logs (i.e. Emergency Room, Operating Room) in hybrid environment.

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: Utilize public laws, hospital regulations and directives covering operational and procedural requirements. Applies judgment and interprets guides/manuals to specific cases. Coordinate efforts of the accuracy, timeliness and reliability of medical records in order to render patient care services, treatment, statistical retrieval, and reimbursement from insurance companies and other third party entities. 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 Gallup Service Unit 516 E Nizhoni Blvd P O Box 1337 Gallup, NM 87301 US
• Name: Navajo Area IHS Human Resources
• Email: [email protected]