Medical Reimbursement Technician

Full Job Description

This position will serve as a Medical Reimbursement Technician within the Chief Operating Officer's office at the Florida Caribbean Consolidated Patient Accounts Center, located in Orlando, FL.

The position is responsible for performing a broad range of duties for medical billings and reimbursable and non-reimbursable collections.

TO QUALIFY FOR THIS POSITION AT THE GS-5 GRADE LEVEL, YOU MUST MEET ONE THE FOLLOWING CRITERIA: SPECIALIZED EXPERIENCE: You must possess 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; and reviewing and determining the appropriateness of administrative data.

NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week.

A full year of work is considered to be 35-40 hours of work per week.

~OR~ EDUCATION SUBSTITUTION: You must 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: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation.

~OR~ COMBINATION OF SPECIALIZED EXPERIENCE AND EDUCATION: You must possess 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: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week.

A full year of work is considered to be 35-40 hours of work per week. Transcripts (unofficial or official) must be submitted with your application materials.

Education cannot be credited without documentation.

TO QUALIFY FOR THIS POSITION AT THE GS-6 GRADE LEVEL, YOU MUST MEET THE FOLLOWING CRITERIA: SPECIALIZED EXPERIENCE: You must possess at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-5) 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: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week.

A full year of work is considered to be 35-40 hours of work 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-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.

Major duties include but are not limited to the following: Validating claims for billing purposes ensuring eligibility and referring questionable coding for review.

Submitting claims to third party health insurance carriers, with knowledge of Medicare coverage benefits. Interpreting third party insurance policies and requirements for billing.

Taking responsibility for Medicare reimbursable billing activities. Following instructions about timeliness, objectives, and relative priorities for doing work.

Handling conflicting goals, objectives, priorities, timelines, and deadlines. Exhibiting flexibility in adapting to changing demands within specific timelines.

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

Using a wide range of office software applications such as Microsoft Access, Excel, and Word. Composing correspondence on a situational basis.

Processing billings using ICD-9-MC, CPT/4, and HCPCS codes. Performing other related duties assigned.

Work Schedule: Monday - Friday, 8:00am - 4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not approved