This position is located at the Phoenix Service Unit (PSU), Phoenix Indian Medical; Center (PIMC), Patient Business Services (PBS) Department, Third Party Billing, Accounts Receivable, and Claims Denial and Appeal Section. The incumbent is part of a team that is responsible for the examination, verification, and maintenance of data involved in processing, tracking, and generating alternate resources reimbursement and performing other related support duties.

Duties

Posts and batches payments received on a daily basis. Also follows-up on non-payments, adjustments, and refunds. Performs audits and medical reviews to ensure documentation and accountability of all health insurance claims submitted submitted for payment. Reviews all incoming correspondence determining whether the claim is final; more medical information is needed; claim needs to be resubmitted; or claim needs to be forwarded for appeal. Communicates directly with third party payers on the eligibility of patients to ensure the information in the RPMS are correct to ensure accurate billing. Establishes day-to-day billing procedures for all third party programs.

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-6: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least a GS-5 level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Review billing insurance claims, post payments received from patients and third party payers, and following up on unpaid accounts. GS-7: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least a GS-6 level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Generate a variety of Third Party and Accounts Receivable reports, printing insurance claim forms and exporting electronic claim batches, and tracking outstanding debt letters. 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]