Medical Reimbursement Technician

Full Job Description

These positions are located at the Mid South Consolidated Patient Accounts Center in Smyrna, TN.

To qualify for this position at the GS-5 grade level, you must meet one of the following requirements: SPECIALIZED EXPERIENCE: One (1) full year of specialized experience that equipped you with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of this Medical Reimbursement Technician position.

To be creditable, specialized experience must have been equivalent to at least the next lower level of Federal service.

Examples of qualifying specialized experience include: 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.

~OR~ EDUCATION: Successfully completed 4 years of education above high school 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.

(Transcript Required) ~OR~ COMBINATION of EDUCATION and EXPERIENCE: Equivalent combination of specialized experience and post high school education as described above that demonstrates my ability to perform the duties of this position.

(Transcript Required).

To qualify for this position at the GS-6 grade level, you must meet the following requirement: SPECIALIZED EXPERIENCE: One (1) full year of specialized experience that equipped you with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the Medical Reimbursement Technician position.

To be creditable, specialized experience must have been equivalent to at least the next lower level of Federal service.

In addition to the examples provided at the GS-05 level, examples of qualifying specialized experience include: Validating claims for billing purposes; Ensuring eligibility and referring questionable coding for review; and Interpreting insurance policies and requirements for billing.

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 include, but are not limited to, the following: Performs verification of patient insurance coverage; Obtains patient insurance information through automated databases, direct patient contacts and contact with insurance companies; Verifies benefits, policy number, pre-certification requirements and effective dates of coverage; Accepts and completes work provided by a standardized control system such as batched work, caseload level or other defined structure; Responsible for Medicare and Commercial insurance reimbursable billing activities; Ensures that all billable cases are identified and that bills are accurately generated; Validates clams for billing purposes ensuring eligibility and referring questionable coding for review; Follows instructions about timeliness, objectives and relative priorities for doing work; Exercises sound judgment to determine the appropriateness of data and information provided on a claim; Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies; Use a wide range of office software applications; Performs other duties as assigned Work Schedule: Monday through Friday, 8:00am to 4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved