ORGANIZATION LOCATION: Phoenix Service Unit, Ak-Chin Clinic. Position is located in Maricopa, AZ., and supervised through Supervisory Health System Specialist. The position provides specialized information, counseling, and assistance services to beneficiaries concerning their health benefits, and advises on all aspects of benefits and services to new and returning patients. This job will close when we have received 25 applications which may be sooner than the closing date.
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: GS-07: 1 year of specialized experience equivalent to at least the GS-07 grade level in the federal service obtained in either the private or public sector performing the following type of work and/or tasks: Certifying the eligibility requirements for health care benefit programs such as Medicare, Medicaid, Social Security Insurance, and similar resources provided by the medical facility; compiling data and writing reports; conducting comprehensive patient interviews to determine eligibility for alternate health insurance resources; providing recommendations to patients on the various health care benefit programs and eligibility criteria based on current health care laws and regulations; conducting extensive research and providing benefit updates involving changes in rules and regulations for alternate resources.. 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.
Performs benefit coordinator duties such as, serving as an advocate for beneficiaries in utilization of alternate resources, providing technical advice and counseling on various benefits, conduct screening and interviews to verify eligibility, establishing eligibility with external entities, coordinates with external entities to establish eligibility, and maintains tracking system of pending applications. Performs contact representative duties such as, data entries into computerized Resources and Patent Management Systems (RPMS), verify beneficiaries' documentation to determine eligibilities, conduct timely entries into Arizona Health Care Cost Containment System (AHCCCS) and Medicare information to augment outpatient and inpatient billing efforts. Performs purchased and referred care duties such as, initiating medical authorizations to verify deferred care, completes and maintains application for medical care, verifies census records for applicants to identify sources, and interprets regulations and policies to health service providers and recipients.