This position is located in the Purchased/Referred Care at an IHS Service Unit. The purpose of the position is to administer the provision of Purchased/Referred Care in compliance with regulatory requirements set forth in the 42 CFR, Subpart 136, to determine patient's eligibility, defining and interpreting PRC regulations and guidelines and maintaining records. Employee identifies and assists patients who may be eligible for coverage by third party resources.

Duties

Implement screening in and interviewing methods to identify eligible for alternate resources. Communicates with patients, facility staff, and a variety of offices that provide alternate resources. Follows up on impending eligibility cases. Provides information on rights and benefits of multiple resources and advice of non-approved or approval of benefits case.

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): 1 year equivalent to at least next lower grade level In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: 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: GS-06-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-05 level in the Federal service as described in the vacancy announcement. Examples include: Retrieve, organize, and prepare medical records upon request; Scan documents; File reports and other pertinent information into the paper record in accordance with regulations; Perform routine clerical duties. GS-07-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-06 level in the Federal service as described in the vacancy announcement. Examples include: Apply policy and regulations related to medical records confidentiality; Analyze and code medical records in automated record systems; File and purge inactive charts; Interact with personnel for corrective coding and data entry. GS-08-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-07 level in the Federal service as described in the vacancy announcement. Examples include: Provide information or rights and benefits of multiple alternate resources and advise patients of nonpayment or approval of claim. 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 Red Lake Service Unit 24760 Hospital Drive Red Lake, MN 56671 US
• Name: Janell Ward
• Phone: 202-597-1220
• Email: [email protected]