Medical Reimbursement Technician

Full Job Description

This position is within the Business Office of the Mid-Atlantic Consolidated Patients Accounts Center located in Asheville, North Carolina.

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): I have successfully completed 4 years of education above high school.

OR COMBINATION OF EXPERIENCE AND EDUCATION (TRANSCRIPT REQUIRED): I have 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: I have 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/ 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/.

Major Duties:

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** ***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 Telework: Ad Hoc Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met.

Selection at a lower grade level does not guarantee promotion to the full performance level.