Medical Reimbursement Technician

Full Job Description

This position is located at the Mid-South Consolidated Patient Accounts Center, Billing and Insurance Verification Departments in Smyrna, TN.

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, applicants must meet all requirements by the closing date of this announcement, 01/22/2026.

Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement.

For a GS-06 position you must have served 52 weeks at the GS-05. The grade may have been in any occupation, but must have been held in the Federal service.

An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.

If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement.

In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade.

Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.

You may qualify based on your experience and/or education as described below: GS-05 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: Follows instructions about timeliness, objectives and relative priorities for doing administrative work.

Communicates with other staff as necessary to discuss administrative concerns. Reviews and determine the appropriateness of administrative data.

OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school.

OR Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond 4 years high school.

GS-06 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: Follows instructions about timeliness, objectives and relative priorities for doing administrative work.

Communicates with other staff as necessary to discuss administrative concerns. Reviews and determine the appropriateness of administrative data.

Validates claims for billing purposes ensuring eligibility and referring questionable coding for review. Interprets 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*** Validate claims for billing purposes ensuring eligibility and referring questionable coding for review.

Submit claims to 3rd party health Insurance Carriers, with knowledge of Medicare coverage benefits. Interprets third party insurance policies and requirements for billing.

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

Handle conflicting goals, objectives, priorities, time-lines, and deadlines. Exhibit flexibility in adapting to changing demands within specific time lines.

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

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

Process billings using ICD-10-MC, CPT/4, and HCPCS codes timely.

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.

Work Schedule: Monday-Friday 08:00am-04:30pm Compressed/Flexible: May be discussed to meet the needs of the agency Position Description/PD#: Medical Reimbursement Technician/PD36017A and PD36018A