Shire Jobs

Summary This position will support the Federal Government's response efforts to COVID-19. This position is a Medical Support Assistant, Purchase Referred Care (PRC), located at the White Earth Service Unit, White Earth, MN. This position reports to the PRC Supervisor or Designee. Responsibilities Initiates medical Authorizations to include hospitalization and professional fees for eligible Indian patients. Maintains denial correspondence files assuring that all appropriate documentation is included in file. Key enters information for automatic document control commitment registers for the health services funds allotted, which requires accurate accountability and a comprehensive knowledge of fiscal coding procedures. Provides the supervisor informal reports on fund status expenditures on a periodic basis. Contacts state agencies and other outside organizations to determine medical eligibility within the service unit jurisdiction. Cross compares proposed authorizations with sources prior to obligating funds for purchased referred care services. Reviews incoming invoices to determine if authorizations have been issued and if not, incumbent researches and takes appropriate action. Answers telephone and written inquiries regarding eligibility requirements, payments, outstanding charges, and other questions concerning the PRC program. Maintains strict confidentiality in responding to inquiries. Prepares routine correspondence and compiles information for periodic special reports. Requirements Conditions of Employment Must pass pre-employment examination. 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. Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities. COVID-19 vaccination is required for all selectees prior to entrance on duty. 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: One (1) year of specialized experience equivalent to at least the GS-04 grade level and/or 4 years above high school. GS-06: One (1) year of Specialized Experience equivalent to at least the GS-05 grade level. GS-07: One (1) year of Specialized Experience equivalent to at least the GS-06 grade level. Examples of Specialized Experience: GS-05: Respond to inquiries and requests through telephone, correspondence and personal visits; Apply funds control techniques; monitor and account for funds allotted; familiar with facility organizational departments and services provided; skill in understanding medical terminology; utilize automated patient management system. GS-06: Apply patient referred/care procedures and regulations, work with funding limitations and policies, technical, administrative and clerical functions related to the patient referral program; proper processing requirements including forms, authorization documents, correspondence and reports; Maintain obligation registers regarding funds for medical services. GS-07: Apply policies, procedures, rules and regulations when determining patient eligibility, availability of services and identification of fiscal resources; Manage funds control techniques to account for allotted funds and preparing statements and reports; operate an automated data program system for patient referral reporting, funds control techniques. Specialized Experience Defined: Experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level. Applicants who have the 1 year of appropriate specialized experience, as indicated in the table, are not required by this standard to have general experience, education above the high school level, or any additional specialized experience to meet the minimum qualification requirements. 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. Additional Information Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed. 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. Recruitment or relocation incentives may be authorized. At least a 6 month service agreement will be required. This position has promotion potential to the GS-07 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.