Medical Reimbursement Technician

Summary

This position is assigned to the Consolidated Patient Account Center (CPAC), Chief Operating Officer (COO), Billing and Insurance Verification Department, performing a broad range of duties to achieve the established and expected results for medical billing and reimbursable and non-reimbursable collections at the VA Medical Center in Leavenworth, KS.

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. Duties include, but may not be limited to the following: Performs verification of patient insurance coverage. Obtains patient insurance information through automated databases, direct patient contact and contact with insurance companies. Verifies benefits, policy number, pre-certification requirements, and effective dates of coverage. Updates and maintains patient information in an electronic database. Generates monthly reports as required. Ensures that all billable cases are identified and that bills are accurately generated. Validates claims for billing purposes, ensuring eligibility, and referring questionable coding for review. Tracks, reviews, and corrects denials. Obtains required information and coordinates completion of forms with patients, staff, and providers. Responds to patients' questions, explaining eligibility requirements, insurance provisions, and billing and payment procedures. Performs third party collection from insurance companies and accounts receivable functions. Verifies the accuracy of payments, resolves problems and discrepancies, and closes out accounts. Performs other related duties as required. Work Schedule: Monday - Friday, 8:00 am until 4:30 pm. Recruitment & Relocation Incentives: Not authorized Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Qualifications

SPECIALIZED EXPERIENCE GS-05: Applicants must possess at least one (1) full year of specialized experience that equipped them with the particular knowledge, skills, and abilities to perform successfully the duties of this position, and that is typically in or related to the work of this position. To be creditable, this experience must have been equivalent to at least the GS-4 level in the Federal service. Examples of specialized experience include: following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with co-workers and supervisors to discuss administrative concerns; and reviewing and determining the appropriateness of administrative data.. NOTE: Experience must be documented within the resume to receive credit indicating clearly the nature of duties and responsibilities in each position, month and year and the number of hours a week spent in such employment. OR SUBSTITUTION OF EDUCATION FOR EXPERIENCE GS-05: You must have successfully completed a bachelor's degree or 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite? This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. NOTE: Transcript required with application. OR COMBINATION OF EDUCATION AND EXPERIENCE GS-05: An equivalent combination of specialized experience and post high school education as described above that demonstrates the ability to perform the duties of this position. NOTE: Transcript required with application. SPECIALIZED EXPERIENCE GS-6: Applicants must possess at least one (1) full year of specialized experience that equipped them with the particular knowledge, skills, and abilities to perform successfully the duties of this position, and that is typically in or related to the work of this position. To be creditable, this experience must have been equivalent to at least the GS-5 level in the Federal service. Examples of specialized experience include: following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with co-workers and supervisors to discuss administrative concerns; reviewing and determining the appropriateness of administrative data; validating claims for billing purposes by ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing. Experience must be documented within the resume to receive credit indicating clearly the nature of duties and responsibilities in each position, month and year and the number of hours a week spent in such employment. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/. 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education at the GS-5 level. There is no educational substitution at the GS-6 grade level. NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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/.