Contact Representative (Benefits)

Full Job Description

Join the Indian Health Service as a Contact Representative (Benefits) and make an impact.

In this role, you will identify patients eligible for alternate health coverage, assist with enrollment, and advocate to ensure they effectively use available benefits.

This position focuses on improving patient access to healthcare resources and supporting overall community well-being.

USAJOBS Help Center - Update your resume now so it meets new resume requirements 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: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Knowledge direct care services regulations, policies and procedures including regulations of the Direct and Purchased Referred Care patient care system; eligibility requirements for Medicare, Medicaid, Social Security Administration, County DHS offices, Tribal programs and alternate funding and resources.

Provided guidance and served as an advocate for patients in the effective utilization resources and the eligibility process.

Identify, assist, follow-up patients on pending applications, ensures entry of multiple alternate resources to augment outpatient and inpatient billing efforts, works closed with other involved parties.

Education: Generally not applicable.

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 by the respective cut-off day of rating to be eligible for consideration. Major Duties:

There MAY NOT be immediate vacancies at all locations.

Alternate Resources Provides guidance and serves as an advocate for patients in the effective utilization of alternate resources and the eligibility process for Medicare, Medicaid, Department of Veteran Affairs, Social Security Administration, Bureau of Employment Compensation, Third Party Liability, Worker's Compensation, Children Special Health Services and Temporary Aid to Needy Families (TANF).

Provides information on rights and benefits of multiple alternate resources, advises of patient of nonpayment or denial of claims, serves as advocate intervening of patient's behalf.

Identifies and follow-up on pending application, works with families and agencies, ensures timely entry of multiple alternate resources to augment outpatient and inpatient billing efforts.

Assists and work closely with all sections related to patient registration, billing, collections and accounts receivable, and health providers in identification, eligibility and utilization of all alternate resources that are available to the native population served.

Provides and maintains communication with all parties involved.

Medicare/Medicaid Assists patients, family members, and all other parties involved in initiating and completing the Medicare and Medicaid applications.

Interprets rules and regulations on usage of the eligibility coverage.

Interviews all patients eligible for Medicare and Medicaid benefits to ensure they understand their fair entitlement in non-IHS and IHS facilities.

Works with various aid programs and other disciplines that may assist in developing registers of eligible patients through their current activities related in determining the health status of the elderly.

Assists the elderlies and their families with application for alternate resources and interprets rules and regulations for Medicare and Medicaid third party coverage.

Coordinates with local, community, county, tribal affiliates and agencies to establish eligibility or provide accurate referrals in establishing eligibility for Medicare, Medicaid, food aid assistance, Social Security Disability, and Supplemental Security Income (SSI).

Assists with completing the Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) Disability enrollment process.

Helps patients and/or families in completing the required forms.

Provides and independently initiates a progressive review of the disability process with the Social Security Administration and the State Developmental and Disability programs.