These positions serve as Medical Reimbursement Technicians within the Business Office performing a broad range of duties to achieve the established Central Office expected results for medical billing, reimbursable/non-reimbursable collections, and insurance verification. Duty location: Middleton, WI.
To qualify at the GS-5 Grade level, you must meet one of the following: SPECIALIZED EXPERIENCE GS-5: You must possess at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-4) in the Federal Service that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician. Specialized experience includes following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; reviewing and determining the appropriateness of administrative data. (Resume(s) must clearly demonstrate the experience to be creditable. We will not make assumptions regarding experience.) OR EDUCATION SUBSTITUTION GS-5: You must have successfully completed four (4) years of education above the high school level in any field which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college, or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. (You must submit a copy of your transcript with your application. Education cannot be credited without documentation.) OR COMBINATION OF SPECIALIZED EXPERIENCE AND EDUCATION GS-5: You must possess equivalent combinations of successfully completed post-high school education (beyond the second year) and specialized experience, as described above, which meet the total experience requirements for this grade level. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college, or university. (You must submit a copy of your transcript with your application. Education cannot be credited without documentation.) To qualify at the GS-6 Grade level, you must meet the following: SPECIALIZED EXPERIENCE GS-6: You must possess at least one (1) full year of specialized experience equivalent to the next lower grade level (GS-5) in Federal service that has equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. Specialized experience includes following instructions about timeliness, objectives, and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; reviewing and determining the appropriateness of administrative data; validating claims for billing purposes ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing. (Resume(s) must clearly demonstrate the experience to be creditable. We will not make assumptions regarding experience.) 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 position involves a multi-grade career ladder. 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. Major duties and responsibilities include: Performs verification of patient insurance coverage. Obtains patient insurance information through automated databases, direct patient contacts and contact with insurance companies. Verifies benefits, policy number, pre-certification requirements, and effective dates of coverage. Accepts and completes work provided by a standardized control system such as batched work, caseload level or other defined structure. Responsible for Medicare reimbursable billing activities. Ensures that all billable cases are identified and that bills are accurately generated. Validates claims for billing purposes, ensuring eligibility, and referring questionable coding for review. Follows instructions about timeliness, objectives and relative priorities for doing work. Exercises sound judgment to determine the appropriateness of data and information provided on a claim. Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies. Use a wide range of office software applications. Follows instructions about timeliness, objectives and relative priorities for doing work. Performs other related duties as required. Work Schedule: Full Time, Monday-Friday, 8:00am to 4:30pm Relocation Incentives: Not authorized Recruitment Incentive: May be authorized for individuals new to federal service or for former federal employees returning to federal service, subject to eligibility and agency approval. Critical Skills Incentive (CSI): Not approved