This position is aligned under the Veterans Health Administration, Office of Finance, and is physically located in Orlando, Florida at the LAKEMONT ANNEX, Florida-Caribbean Consolidated Patient Account Center (CPAC), in either the Billing or Insurance Verification departments. The Medical Reimbursement Technician performs a broad range of duties to achieve the established Central Office VISN 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, 07/25/2025. (GS-06 Only) 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. 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, GS-05 Substitution of Education for Experience: 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. (TRANSCRIPTS REQUIRED) OR, GS-05 Combination of Education and Experience: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond 4 years above high school. (TRANSCRIPTS REQUIRED) 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. You will be rated on the following Competencies for this position: Customer Service (Clerical/Technical) Decision Making Manages and Organizes Information Self-Management Technical Competence 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements: The work is primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort. 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/.
***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** This is a multi-grade career ladder position. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. 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: 8:00am - 4:30pm Compressed/Flexible: Not Authorized Telework: Not Authorized Virtual: This is not a virtual position. Position Description/PD#: Medical Reimbursement Technician/PD36018A and PD36017A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized