Uniform Business Office Technician

Full Job Description

About the Position: This position is located at Defense Health Network Pacific Rim, San Diego, CA Directorate of RM Financial Management.

The incumbent is responsible for performing duties as assigned which assist in solving difficult and complex problems in the areas of Medical Services Account (MSA), Third Party Collection (TPC), Medical Affirmative Claims (MAC), Elective Cosmetic Surgery (ECS) and Inter-Agency Billing (IAB) programs.

This is a Direct Hire Solicitation Who May Apply: US Citizens In order to qualify, you must meet the education requirements described below.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social).

You will receive credit for all qualifying experience, including volunteer experience.

Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application.

Additional information about transcripts is in this document.

Specialized Experience: One year of specialized experience which includes: (1) generating health insurance claims to third party payers and/or responsible parties; and (2) utilizing automation systems to retrieve health insurance information and (3) re-billing or correcting billing of accounts previously submitted.

This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). Major Duties:

• Analyzes and performs work necessary to accomplish work processes by using numerous manual and automation systems and software programs necessary for billing operations.
• Compares account balances in various financial and billing information systems with related data to assure agreement.
• Utilizes a thorough knowledge of medical terminology and disease processes to analyze each record of treatment to ascertain which visits are related to the claim in question.
• Identifies sources of reimbursable earnings and ensuring accurate billing, collecting, depositing and reporting of these earnings.
• Responsible for daily operation for all aspects of reimbursable account management assuring that billing and collection procedures comply with policies and procedures directed by higher authority.
• Receive daily encounter forms or computer downloads from all clinical services reflecting care patient received. Review each encounter for consistency, accuracy, and completeness of data.