Medical Reimbursement Technician chez Department of Veterans Affairs

Other

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** Duties include but may not be limited to: Verification of Veterans' insurance coverage for inpatient and outpatient services. Documents pre-admission requirements. Responsible for all reimbursable billing activities to include billing consideration of professional and facility services. Validates Claims for billing purposes. Third party collections from insurance companies. Verifies accuracy of payments, resolves problems and discrepancies and closes out accounts. Responds to questions and inquiries from veterans and insurance companies. Explains eligibility and entitlements to veterans. Audits accounts, insuring payments recovered by insurance carrier are posted in a timely manner. Work Schedule: Monday-Friday, 8:00am - 4:30pm Recruitment & Relocation Incentives: Not authorized

Requirements

You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) - See "Required Documents" below for details. As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

For the GS 5 position you must possess the following qualifications: SPECIALIZED EXPERIENCE: At least one (1) year of specialized experience equivalent to the next lower grade level (GS 4) in Federal Service that includes performing the following duties: Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies.; Interprets insurance policies and requirements for billing.; Submits claims to health Insurance Carriers.; Uses a wide range of office software applications.; Exhibits flexibility in adapting to changing demands within specific timelines. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding experience.) OR SUBSTITUTION OF EDUCATION FOR EXPERIENCE (TRANSCRIPT REQUIRED): Successful completion of 4 years of education above high school. OR COMBINATION OF EXPERIENCE AND EDUCATION (TRANSCRIPT REQUIRED): Equivalent combinations of successfully completed graduate-level education (beyond 18 semester hours) and specialized experience, as described above, which meet the total experience requirements for this grade level. The education portion must include graduate courses directly related to the work of this position. For the GS 6 position you must possess the following qualifications: SPECIALIZED EXPERIENCE: At least one (1) year of specialized experience equivalent to the next lower grade level (GS 5) in Federal Service that includes performing the following duties: Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies.; Interprets insurance policies and requirements for billing.; Submits claims to health Insurance Carriers.; Uses a wide range of office software applications.; Exhibits flexibility in adapting to changing demands within specific timelines. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding 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. 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/.

Other Information

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. 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. This job opportunity announcement may be used to fill additional vacancies. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act. 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 80 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/. Note: Per "Executive Order 14251: Exclusions from Federal Labor-Management Relations Programs", this position is no longer eligible for bargaining unit participation.