Medical Reimbursement Technician

Full Job Description

These positions are located at the Northern-Central Consolidated Patient Account Center, Billing and Insurance Verification Departments in Middleton, WI.

The Medical Reimbursement Technician performs a broad range of duties to achieve established and expected results for medical billing and reimbursable and non-reimbursable collections.

TO QUALIFY FOR THIS POSITION AT THE GS-5 LEVEL YOU MUST MEET THE FOLLOWING CRITERIA: SPECIALIZED EXPERIENCE: Have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-4) in the Federal Service that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician.

Specialized experience includes 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.

-OR- EDUCATION: Have successfully completed four (4) years of education above the high school level in any field 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.

One year of full-time academic 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, secretarial, or technical school.

NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation.

-OR- COMBINATION: Have equivalent combinations of successfully completed post-high school education (beyond the second year) and specialized experience, as described above, which meet the total experience requirements for this grade level.

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

NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation.

TO QUALIFY FOR THIS POSITION AT THE GS-6 LEVEL YOU MUST MEET THE FOLLOWING CRITERIA: SPECIALIZED EXPERIENCE: Possess at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-05) in the Federal Service that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician.

Specialized experience includes 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; verifying claims for billing purposes ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing.

NOTE: Applicants wishing to receive credit for such experience must clearly indicate the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.

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-6. At the GS-5 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-6.

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

Duties may include, but are not limited to the following: Performs verification of veterans' insurance coverage for inpatient and outpatient services.

Verifies benefits, policy number, pre-certification requirements, insurance company contact Information, and effective dates of coverage.

Ensures that all billable cases are identified and that bills are generated. Validates claims for billing purposes ensuring eligibility and referring questionable coding for review.

Monitors reports to ensure all possible billable cases are processed. Follow instructions about timeliness, objectives, and relative priorities for doing work.

Use a wide range of office software applications such as Microsoft Access, Excel, and Word. Reviews and determine the appropriateness of administrative data.

Accept and completes work provided by a standardized control system such as batched work, caseload level, or other defined structure.

Communicates with other staff as necessary to discuss administrative concerns. Performs other related duties as assigned.

Work Schedule: Monday-Friday, 8:00am-4:30pm Recruitment & Relocation Incentives: Recruitment incentive is authorized for a highly qualified applicant. Critical Skills Incentive (CSI): Not Approved