Summary
This position is located in the Business Office at the Warm Springs Service Unit in Warm Springs, Oregon. Work is to process billing claims to third party carriers, which include Medicare Part D, Medicaid and Private Insurance. This position reports to the Business Office Manager.
If selected, the GS-05 candidate gains experience toward the full performance level of GS-07 once qualifications requirements met.
Recruitment or relocation incentives may be authorized.
Duties
The position is located in an Ambulatory health care center located on the Confederated Tribes of Warm Springs reservation. For more information on the Warm Springs Health and Wellness Center, visit the .
If incumbent is hired at the GS-05 level, the selected candidate gains experience toward the full performance level of the GS-07 to perform the duties:
- Prepares and submits claims to third party payers, intermediaries, and responsible parties.
- Maintains records and files in accordance with applicable regulations and guidance.
- Reviews system generated reports daily to identify claims that are ready for billing.
- Documents to the insurance companies when requested for an audit.
- Checks for errors and makes correction for all rejected/suspended claims previously submitted to third party payers and intermediaries and patients.
- Prepares end of month and quarterly status reports which includes amounts billed, collected and outstanding.
- Researches and follows-up on rejected claims on-line.
Requirements
Conditions of Employment
Selectee may be subject to a probationary period.
U.S. Citizenship is required.
Selective Service Registration is required for males born after 12/31/1959
This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities.
COVID-19 vaccination is required for all selectees prior to entrance on duty.
Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit .
You will need to set up direct deposit so we can pay you.
Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process.
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-05
- Your resume must demonstrate at least one (1) year of specialized experience equivalent comparable in difficulty and responsibility to the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Compile account statements, compute balances and record billing payments for any company. Responsible for preparing invoices for services rendered or for the delivery of goods. Calculate interest, penalties and late fees for clients who are past due on their accounts. Work daily with both paper forms and specialized computer programs when inputting and analyzing account information;
- OR, 4 years of education above the high school level.
- OR, possess a combination of education and experience that when combined fully meet the minimum qualifications for the GS-05 grade level. (Only education in excess of the first 60 semester hours is creditable toward meeting the specialized experience requirement). The total percentage must equal at least 100 percent to qualify an applicant for GS-05 grade level.
MINIMUM QUALIFICATIONS: Grade GS-06
- Your resume must demonstrate at least one (1) year of specialized experience specialized experience comparable in difficulty and responsibility to the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Analyzing billing operations for third party (health care) programs; acting as an advocate in the collection of alternate resources (insurance, Medicaid etc.); assuring collections, billed data and computerized and manual reports are in balance; and ensuring accountability of health insurance claims submitted for payment.
MINIMUM QUALIFICATIONS: Grade GS-07
- Your resume must demonstrate at least one (1) year of specialized experience specialized experience comparable in difficulty and responsibility to the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: submit claims to third party payers and responsible parties, rebill or correct billing of accounts previously submitted; verify information, review reports to identify claims and use the various types of computer systems; searches and retrieves individual patient records to gather and compile information for outpatient services.
You must meet all qualification requirements within 30 days of the closing date of the announcement.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
If you meet the minimum qualifications requirements for this position, your application will be evaluated and rated under Category Rating selection procedures. Once the application process is complete, a review of your qualifications will be conducted to determine if you are qualified for this job. Qualified candidates will be assigned to a quality category. The quality categories are: Best Qualified, Well Qualified, or Qualified. Within each of these categories, applicants eligible for veteran's preference will receive selection priority over non-preference eligibles.
Please note that if, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your category rating can and will be adjusted to more accurately reflect your abilities, or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.
To determine if you are qualified for this position, a review of your resume and supporting documentation will be made and compared against the qualifications as defined in the qualifications section of this vacancy announcement and your responses to the assessment questions. You will be rated based on the information provided in your resume (your resume must state specific duties that relate to this position) and your responses to the assessment questions will be evaluated against the duties you provided in your resume, along with your submitted documentation to determine your ability to demonstrate the following.
- Attention to Detail
- Customer Service (Clerical/Technical)
- Technical Competence
- Technology Application
The following links below provide information on how you may be eligible for various hiring authorities. If you are a Veteran, qualified CTAP and ICTAP eligible, or an individual with a disability, please refer to the following links below for additional guidance. CTAP and ICTAP candidates will be eligible for selection priority if it is determined that they have exceeded the minimum qualifications for the position by attaining at least a "well qualified" rating of 85 out of 100. Information about CTAP and ICTAP eligibility is on the Office of Personnel Management's Workforce Restructuring Career Transition website at: . CTAP/ICTAP documentation requirements are listed in the "Required Documents" section of this announcement.
- Veterans, i.e. (VEOA, VRA, and 30% or more disabled) -
- Career Transition Assistance Program (CTAP) -
- Interagency Transition Assistance Program (ICTAP) -
- Schedule A Appointments for the Disabled -
Click here to view vacancy questions: . All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the closing date of, 11/25/2024, to be considered.
Required Documents
Resume: You are highly encouraged to use to ensure all required information is included in your Resume.
If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes:
- beginning and ending dates for paid and non-paid work experience
- hours worked per week
- month and year of employment for each job title listed
- annual salary
- description of job duties,
- Include name and address of employer, supervisor name and telephone number.
Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: . When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application () along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: .
Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: .
Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application. You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer.
You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the closing date: 11/25/2024
