Shire Jobs

Summary This position is located within the Billings Area Indian Health Services, Blackfeet Service Unit, Business Office, Browning MT. Incumbent works as an entry level Voucher Examiner, who monitors and oversees the billing operations, third-party reimbursement, audits, medical reviews, and functions as an advocate in the collections of alternative resources. Responsibilities Works to complete general transactions and compiling reports for third party billing activities and accounts. Works with large integrated data systems that include medical, fiscal and management data in numerous related computer files. Identifies audits, posts and collects from third party health plan carriers for outpatient clients to recover maximum dollars. Assists in developing statistical reports and control methods in determining receivable and collections. Responsible for accurate processing of secondary and tertiary billing after posting payment of initial claims. Maintains documents of all activity related/performed on patient accounts in patient financial folder. Documentation will include dates, telephone numbers, name or person contacted with the status of payment. Requirements Conditions of Employment Selectee may be subject to a probationary/trial period ESEP appointees typically serve a two year trial period U.S. Citizenship is required Selective Service Registration is required for males born after 12/31/1959 This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Adherence to the IHS Employee Immunization Policy, SGM 21-04, and the IHS Circular 2016-04 requiring Measles and Rubella, COVID-19, and seasonal influenza immunizations for staff working in Indian Health Service health care facilities OR an exemption request will need to be submitted. Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/. You will need to set up direct deposit so we can pay you. Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process. Qualifications To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Responsible office work to include processing of business transactions, such as the inputting, reviewing, organizing and analyzing of data as accomplished through the use of automated database and/or electronic business systems. OR Completion of 4 years of education above the high school level. OR A combination of education and experience. Only education in excess of the first 60 semester hours is creditable toward meeting the specialized experience requirement. GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Progressively responsible office work to include processing of business transactions, such as the inputting, reviewing, organizing and analyzing of data as accomplished through the use of automated database and/or electronic business systems; preparing and reviewing documents to verify data and to identify necessary entries into automated database and/or electronic business systems; maintaining manual filing systems; and working to resolve unpaid balances. GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Processing third party health plan transactions, generating and analyzing aged summary reports, maintaining patient accounts in automated systems to include posting claim payments and adjustments, monitoring claim payment rollover to secondary and tertiary billing, monitor account balances, review posting to ensure accuracy, and recommend appropriate correction action, performing account reconciliation, maintaining manual filing system of records related to collections, denials, and other pertinent revenue cycle documents, coordinating collection of open patient accounts and working closely with internal stakeholders and external agencies and third party payers to resolve unpaid balances for medical services rendered, compiling reports for third party billing activities and accounts Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement. Education There are no education requirements, however if you are planning to substitute experience for education at the GS-05 (only), you are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer. Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation.If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information This position is eligible for workplace flexibilities which may include remote work or telework options, and/or flexible work scheduling. These flexibilities may be requested in accordance with the HHS Workplace Flexibilities policy. https://www.hhs.gov/about/agencies/asa/ohr/hr-library/990-1/index.html. Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. This position is covered by a Bargaining Unit. This position meets the criteria specified in pillar number one of the five pillars of the PHS Commissioned Corps. PHS Commissioned Officers interested in performing the duties of this position within the Commissioned Corps MUST apply online under the merit promotion announcement indicated above in order to receive consideration. For more information on PHS Commissioned Corps, visit the website at: https://www.usphs.gov/. This position has promotion potential to the GS-7 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.