Medical Insurance Technician (Office Automatiion)

Full Job Description

About the Position: This position is with the Defense Health Agency, located at Tripler Army Medical Center, Directorate of Resource Management, Honolulu Hawaii.

Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job.

You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected.

Current Civilian Employees of the Defense Health Agency (DHA) Current Permanent Department of Defense (DoD) Civilian Employee Domestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel Workforce Interagency Career Transition Assistance Plan Land Management Workforce Flexibility Act Military Spouses, under Executive Order (E.O.) 13473 Non-Appropriated Fund Instrumentality (NAFI) Non-Department of Defense (DoD) Transfer Office of Personnel Management (OPM) Interchange Agreement Eligible Priority Placement Program, DoD Military Reserve (MR) and National Guard (NG) Technician Eligible Priority Placement Program, DoD Military Spouse Preference (MSP) Eligible Priority Placement Program, DoD MR and NG Preference Eligible Tech Receiving Disability Retirement Priority Placement Program, DoD Retained Grade Preference Eligible Reinstatement Veterans Employment Opportunity Act (VEOA) of 1998 In order to qualify, you must meet the experience requirements described below.

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).

You will receive credit for all qualifying experience, including volunteer experience.

Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application.

Additional information about transcripts is in this document.

Specialized experience: One year of specialized experience which includes experience processing patient billings, analyzing accounts receivable, reviewing patient accounts for accuracy and completeness of data, and identifying errors and inaccuracies.

This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06).

Proficiency Required: This position requires a qualified typist. A qualified typist can type 40 words per minute based on a 5 minute sample with three or fewer errors.

Some federal jobs allow you to substitute your education for the required experience in order to qualify.

For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.

Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06).

Major Duties:

• Manage a Third-Party Collection program to include patient account management, billings, tracking of outstanding accounts receivable, follow-up of open claims, and periodic reporting requirements.
• Receive and respond to a wide variety of correspondence and telephone inquiries generated by third party insurance carriers, beneficiaries and others relating to the Uniform Business Office Program.
• Resolve issues related to improperly coded or formatted bills, claim appeals and denials and corrects billing documents to facilitate payment of disputed or rejected bills.
• Act as key trainer to new department employees on team policies/procedures.
• Research patient records and reconstruct incorrect or missing medical information required to prepare a valid insurance billing.
• Determine appropriate billing amount utilizing the most current billing methodology provided by the Tricare Management Activity.
• Review and update billing information to ensure accurate records are kept.
• Investigate and evaluate patient account information, medical records and bills, billing and reimbursement regulations to resolve delinquent payment issues of complex.