This position is organizationally located in the Purchased and Referred Care (PRC) program at the Phoenix Indian Medical Center (PIMC) located in Phoenix, AZ. The purpose of this position is to provide support and technical assistance to the Service Unit management on matters involving processing PRC claims and purchase orders. Incumbent serves as the Supervisor of the claims section within the PRC program.

Duties

Work requires application of administrative and analytical skills and techniques to ensure that PRC programs and private contractors are abiding by the established requirements and practices as it pertains to payments for services rendered. Serve as the specialist responsible for evaluating and reporting on the PRC claims section program provided by PIMC and its service unit Tribes. Participates in activities involved in the planning and implementation of the Resource and patient Management System (RPMS), PRC and referred care information system (RCIS) software. Serves as the Claims Supervisor over the claims staff working in the Purchased Referred Care.

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. BASIC REQUIREMENT(S): Undergraduate and Graduate Education: Major Study - hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. MINIMUM QUALIFICATIONS: In addition, to the Basic Requirements, you must also meet the Minimum Qualifications stated below-Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-11 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Knowledge of PRC policies and procedures. Comprehensive knowledge of health care delivery system; regulatory agencies, i.e., Centers for Medicaid and Medicare Services (CMS), The Joint Commission (TJC), etc., federal regulations, i.e. Privacy Act of 1974, HIPAA, etc., and IHS statutes and policies. Knowledge of Third-Party billing and payer 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

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 Phoenix Service Unit 1616 E Indian School Rd Suite 360 Phoenix, AZ 85016 US
• Name: Phoenix Area IHS Human Resources
• Email: [email protected]