Medical Reimbursement Technician

Company: Veterans Affairs, Veterans Health Administration
Location: Smyrna
Posted on: May 20, 2023

Job Description:

Summary This position serves as a Medical Reimbursement Technician assigned to the Consolidated Patient Account Center (CPAC) located at the Veterans Healthcare Administration in Smyrna, TN. Responsibilities 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. Some of the duties and responsibilities of this position include (but are not limited to): Performs verification of patients' insurance coverage for inpatient/outpatient services; Enters information and maintains databases. Documents pre-admission requirements and identifies patients requiring second opinions. Performs re-imbursement billing activities, including consideration of professional and facility services, sharing agreements, Tricare, Champ VA, Medical, and Pharmacy billing. Validates claims for billing purposes ensuring eligibility and refers questionable coding for review. Monitors reports to assure all possible billable cases are processed, ensuring proper sequencing of diagnostic and procedural codes; tracks, reviews, and corrects denials. Responsible for the integrity of the insurance databases, for updating information in the system, and generating reports. Communicates with insurance companies and patients answering questions/inquires and explains health care services eligibility and entitlements to patients. Performs other related duties as assigned. Work Schedule: Monday-Friday, 8:00 am - 4:30 pm Recruitment & Relocation Incentives: Not authorized Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Financial Disclosure Report: Not Required Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details. Qualifications In order to qualify for this position, applicants must possess at least one of the following minimum qualifications: SPECIALIZED EXPERIENCE: Possess one full year of specialized experience equivalent to the next lower grade level in federal service. Specific qualifying specialized experience for this position (which should be documented on your resume) is: performing medical billing, healthcare reimbursement, and accounts receivables; verifying patient insurance coverage and eligibility; collecting from third party insurance companies; coding actions utilizing the International Statistical Classification of Diseases and Related Health Problems (ICD-9), Current Procedural Terminology (CPT) and the Health Care Common Procedural Coding System (HCPCS); and utilizing a wide range of software applications. Your answer will be verified against information provided on your resume. If your resume does not clearly support your response by addressing your work experience in detail you will be disqualified. OR EDUCATION SUBSTITUTION: Successfully completed 4 years of education above the high school level. NOTE TO APPLICANTS: 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. (TRANSCRIPTS REQUIRED - If you do not submit a copy of your transcript, your application may not be processed.) OR COMBINATION: Possess equivalent combinations of experience and education as previously described to fully meet the requirements of this position. For GS-5 level positions, only education in excess of the first 60 semester hours of a course of study leading to a bachelor's degree is creditable toward meeting the specialized experience requirements. Two full academic years of study, or 60 semester hours, beyond the second year is equivalent to l year of specialized experience. (TRANSCRIPTS REQUIRED - If you do not submit a copy of your transcript, your application may not be processed.) You will be rated on the following Competencies as part of the assessment questionnaire for this position: Customer Service (Clerical/Technical) Decision Making Manages and Organizes Information Self-Management Technical Competence IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. 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; 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. 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/. Education IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. Additional Information Physical Requirements: The work may require some physical effort such as, periods of standing, walking, or bending. There are no special physical demands. The work involved ever day risks/discomforts associated with work in an office setting, requiring normal safety precautions. Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities (i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities), and/or disabled veterans with a compensable service-connected disability of 30% or more. For more information on how to apply using this appointment authority via the Selective Placement Coordinator within the office, contact the facility Human Resources Department at (615) 355-3465. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 85 or more before any Veterans preference points) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. This job opportunity announcement may be used to fill additional vacancies. To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce the COVID-19 vaccination requirement pursuant to Executive Order 14043 on Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a VA job announcement includes language requiring applicants to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply to this Job Announcement. VA may request information regarding your vaccination status, if selected, for the purposes of implementing other workplace safety protocols, such as masking, physical distancing, testing, travel, and quarantine. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

Keywords: Veterans Affairs, Veterans Health Administration, Smyrna , Medical Reimbursement Technician, Healthcare , Smyrna, Tennessee