Medical Reimbursement Technician

Full Job Description

This position is located in the Consolidated Patient Account Center at VA Eastern Kansas Healthcare service - Dwight D. Eisenhower VA Medical Center in Leavenworth, KS.

The Medical Reimbursement Technician is responsible for performing a broad range of duties to achieve the established Central Office NISN expected results for medical billings and reimbursable and no- reimbursable collections.

Minimum Requirement: The following are minimum requirements for appointment as a Medical Reimbursement Technician in the Veterans Health Administration (VHA), which all applicants must met.

GS-05 Specialized Experience (GS-05): You must have one (1) year of specialized experience that equipped you with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled.

To be creditable, specialized experience must have been equivalent to at least the next lower grade level (i.e., GS-04).

Qualifying examples of specialized experience would typically include but are not limited to: following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; and reviewing and determining the appropriateness of administrative data.

(CLEAR DETAILS OF EXPERIENCE REQUIRED: Your resume must show complete information for each job entry, such as beginning and ending dates of employment, duties performed, and/or total hours worked per week.) OR, Education (GS-05): Applicants may substitute education for the required experience.

To qualify based on education for this grade level you must have four (4) years of successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite.

This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university.

NOTE: One year of full-time undergraduate study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business or technical school.

(UNOFFICIAL TRANSCRIPT REQUIRED: If you do not submit your transcript, your application may not be reviewed.) OR, Combination (GS-05): Applicants may also combine education and experience to qualify at this level.

You must have a combination of specialized experience and education as described above.

For GS-5 level positions, only education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement.

One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience.(UNOFFICIAL TRANSCRIPT REQUIRED: If you do not submit your transcript, your application may not be reviewed.) GS-06 Specialized Experience (GS-06): You must have one (1) year of specialized experience that equipped you with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled.

To be creditable, specialized experience must have been equivalent to at least the next lower grade level (i.e., GS-05).

Qualifying examples of specialized experience would typically include but are not limited to: following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; reviewing and determining the appropriateness of administrative data; validating claims for billing purposes; ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing.

(CLEAR DETAILS OF EXPERIENCE REQUIRED: Your resume must show complete information for each job entry, such as beginning and ending dates of employment, duties performed, and/or total hours worked per week.) 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 position involves a multi-grade career ladder.

The major duties listed below represent the full performance level of GS-06. At the GS-05 grade level, you will perform assignments of a more limited scope and with less independence.

You will progressively acquire the background necessary to perform at the full performance level of GS-06.

Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds.

Major duties and responsibilities include but not limited to: Verifying veterans' insurance coverage for inpatient and outpatient services and maintaining accurate database records Documenting pre-admission requirements and assisting with pre-certification processes and reporting Managing reimbursable billing activities across multiple programs (e.g., Medicare, Tricare, Champ VA, pharmacy) Identifying billable cases and generating accurate bills in coordination with patients, staff, and providers Validating claims, reviewing coding accuracy, and ensuring proper sequencing of diagnostic and procedural codes Tracking, reviewing, and resolving claim denials while explaining billing and eligibility information to veterans Handling third-party collections and managing accounts receivable for various insurance categories Researching and resolving payment issues, posting payments and adjustments, and processing overpayment refunds Following up on accounts receivable to ensure timely and accurate reimbursement from insurance companies Verifying payment accuracy, resolving discrepancies, and closing out accounts using electronic systems Responding to inquiries from veterans, insurance companies, and contributing to Congressional responses Auditing accounts to ensure timely posting of payments and proper financial tracking Processing vouchers, managing debt collection activities, and handling Treasury Offset program requirements Adjusting veteran accounts after debt offsets and ensuring proper financial reconciliation Performing additional related administrative and financial duties as assigned Work Schedule: Monday to Friday; 08:00 a.m.

to 04:30 p.m. Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved