Reimbursable Billing Technician

This position is located in the North-Central Consolidated Patient Account Center at the Department of Veterans Affairs (VA) - Veterans Health Administration (VHA) - VA Medical Center - in multiple locations. The primary purpose of this position is to perform a variety of functions - including enhancing revenue - using an industry best model built on regional management of key aspects of the revenue cycle - process standardization - accountability - and economies of scale.

This position is located in the North-Central Consolidated Patient Account Center at the Department of Veterans Affairs (VA) - Veterans Health Administration (VHA) - VA Medical Center - in multiple locations. The primary purpose of this position is to perform a variety of functions - including enhancing revenue - using an industry best model built on regional management of key aspects of the revenue cycle - process standardization - accountability - and economies of scale.

To apply for this position - you must have the following qualifications:
To qualify for this position at the GS-6 level - you must meet the following: SPECIALIZED

EXPERIENCE:

At least one (1) full year of specialized experience - equivalent to at least the GS-5 grade level - that equipped you with the particular knowledge - skills - and abilities (KSA's) to successfully perform the duties of the position - and that is typically in or related to the work of the position to be filled. Specialized experience is: providing customer service;

educating patients; reviews - analyzes - process and completes co-payments and insurance for billing; reviews and processes specialty billing; reviews - analyzes - researches - and verifies insurance policy coverage and filing deadlines.

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://(Use the "Apply for this Job" box below)..

• *** THIS IS NOT A VIRTUAL POSITION - YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION
  *** Major duties and responsibilities will include:
  Cooperates with personnel within other organizational units in the wider employing organization to solve revenue problems applicable to Veteran accounts
• Validating claims for billing purposes ensuring eligibility and referring questionable coding for review
• Interpreting third party insurance policies and requirements for billing
• Submitting claims to third party health insurance carriers - with knowledge of Medicare coverage benefits
• Taking responsibility for Medicare reimbursable billing activities
• Obtains data and other information from VA-specific change notifications and ad-hoc reports to proactively or retroactively correct 1st and 3rd party billing
• Reviews for accuracy - adequacy of the documentation - compliance with regulations - and the justification of the action Following instructions about timeliness - objectives - and relative priorities for doing work
• Exhibiting flexibility in adapting to changing demands within specific timelines
• Receives workload from multiple worklist systems - electronic and mail notifications - VA specific internal and external data applications - emails - letters - and face-to-face customer service interactions
• Accepting and completing work provided by a standardized control system such as batched work - caseload level - or other defined structure
• Handling conflicting goals - objectives - priorities - timelines - and deadlines
• Using a wide range of office software applications such as Microsoft Access
  - Excel - and Word
• Composing correspondence on a situational basis
• Analyzes each voucher or invoice to determine propriety of payment to include required certifications by authorized officials - compliance with contract provisions - price agreements - and/or other directives
• Conducts analysis to develop required data and information reporting purposes and drafts brief factual administrative reports
• Performs daily reviews - audits - and/or corrective actions in response to workload activities or requests received directly from Veteran customers
  - Office of General Counsel - internal and/or external compliance and quality…