This position is located in the U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP), Division of Federal Employees', Longshore & Harbor Workers' Compensation (DFELHWC), Federal Employees' Compensation, Branch of Fiscal Operations (BFO).
- This position is located inside the bargaining unit.
- Additional selections may be made from this announcement.
- This is a remote position.
- Selections can be made at any advertised grade(s).
Summary
This position is located in the U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP), Division of Federal Employees', Longshore & Harbor Workers' Compensation (DFELHWC), Federal Employees' Compensation, Branch of Fiscal Operations (BFO).
- This position is located inside the bargaining unit.
- Additional selections may be made from this announcement.
- This is a remote position.
- Selections can be made at any advertised grade(s).
Occasional travel - Minimal travel may be required for training and audit purposes.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time - Remote Work
Service
Competitive
Promotion potential
11 - There is no obligation to provide future promotions if you are selected. Promotions are dependent on your ability to perform the duties at a higher level, meet all the performance requirements, and supervisor’s recommendation to the next grade.
Open to all U.S. Citizens and ICTAP/CTAP eligibles.
Also advertised as job #MS-22-PHIL-OWCP-0202 for status applicants, VEOA eligible; Military Spouses; LandBase Management .
To be considered for each vacancy, apply to BOTH jobs.
- Salary posted reflects nationwide locality pay range. Once the selection has been made, the salary will be set per the selectee's home worksite.
The mission of the DFELHWC is to administer the Federal Employees' Compensation Act (FECA, 5 U.S.C. § 8101 et. seq.) and related regulation and procedure by developing and adjudicating new claims for benefits.
Duties include, but are not limited to:
GS-07 Duties-
Serves as a specialist responsible for medical authorization and bill processing system, including use of all systems used by OWCP and its contractors to process bills and determine appropriate medical authorization.
Receives and responds to medical authorization and billing inquires that require actions by the contract bill processor and/or DFELHWC.
Provides effective customer service, including answering incoming phone calls from medical providers, claimants, and other claim stakeholders to provide technical assistance to a variety of medical authorization and bill related questions.
Responsible for reporting issues or systemic problems.
Identify and reports unresolved issues and new policy issues to Senior Medical Treatment Specialist and supervisors for appropriate actions.
Assists medical providers with inquiries about the relationship of their medical bill coding.
Provides general information and compliance assistance to claimants, IME physicians, field nurses, and rehabilitation counselors on billing issues and problems.
Acts as a conduit for basic concerns from providers and interacts with the contractor.
May participate in reviews of DFELHWC medical coding processes.
Reviews reports from the contract bill processing facility to identify issue that could ensure accuracy and compliance with procedures, methods and deadlines, and quality of service.
Conducts a quality review to audit bills as instructed and provides feedback to management on related problems and recommends corrective action plans.
GS-09 Duties- The overall assignments in this position are substantially the same as the description for the GS-11 except for the following:
Incumbent works under closer than normal supervision at the journeyman level performing assignments designed to provide the competencies, skills, and experience required to perform the more complex work at the full performance grade level.
GS-11 Duties-
Translates the most technical narrative medical reports into accurate medical codes.
Receives, monitors, communicates, intervenes, and responds to medical authorization and billing inquires that require actions by the contract bill processor and/or DFELHWC.
Facilitates and takes all necessary actions to ensure expeditious resolution of complex issues or problems related to medical authorizations and medical bill payments.
Provides effective customer service, including answering incoming phone calls from medical providers, claimants, and other claim stakeholders to provide technical assistance to a variety of medical authorization and bill related questions.
When speaking with medical providers, claimants and other claim stakeholders, the incumbent queries them about the nature of their questions to ascertain how to effectively address their concerns and advises on the proper course of action for that situation.
Responsible for spotting trends of systemic problems and conducting analysis to resolve and correct any negative elements of the bill payment and medical authorization process.
Serves as a technical specialist on the medical authorization and bill processing system, including use of all systems used by OWCP and its contractors to process bills and determine appropriate medical authorization.
Conducts training for federal agencies, healthcare providers and/or their staff.
Provides technical and compliance assistance to claimants, IME physicians, field nurses, and rehabilitation counselors on billing issues and problems, DFELHWC policies and procedures, and fee schedule interpretations.
Serves as a resource for the contract bill processor to ensure enrollment of providers.
Acts as a conduit for all complaints from providers and interacts with the contractor and DFELHWC staff through resolution of the complaint.
Independently decides all fee schedule appeals resulting from the application of the OWCP fee schedules or other cost containment initiatives.
Coordinates, implements, and monitors utilization reviews of bill payment processes.
Responsible for spotting errors or trends of systemic problems and conducting analysis to resolve and correct any negative elements of the bill payment process.
Analyzes correspondence to identify trends and potential problem areas.
Conducts a quality assurance program to audit bills on a regular basis and produces reports that analyze problems and recommend corrective action plans.
Conducts studies of limited scope or segments of more complex issues as assigned for the purpose of developing or evaluating OWCP billing policies and makes recommendations.
Appointment to this position may require a background investigation.
Requires a probationary period if the requirement has not been met.
Must be at least 16 years old and a U.S. Citizen.
Candidate required to obtain the necessary security/investigation level.
Applicants must meet all legal and regulatory requirements. Reference the "Required Documents" section for additional requirements.
Notification Concerning COVID-19 Vaccinations. As required by Executive Order 14043, Federal executive branch employees are required to be fully vaccinated against COVID-19 regardless of the employee's duty location or work arrangement (e.g., telework, remote work, etc.), subject to such exceptions as required by law. If selected, you will be required to be vaccinated against COVID-19 and to submit documentation of proof of vaccination or to be in the process of requesting an exception to the vaccination requirement before appointment or onboarding with the agency. The agency will provide additional information regarding which forms of documentation can be accepted and how you can request to be considered for a legally required exception from this requirement.
Currently, implementation and enforcement of Executive Order 14043 has been suspended pursuant to an injunction pending further litigation.
Qualifications
IN DESCRIBING YOUR EXPERIENCE PLEASE BE CLEAR AND SPECIFIC, PLEASE USE THIS FORMAT MM/DD/YYYY WHEN DATING YOUR EXPERIENCE. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR SPECIALIZED EXPERIENCE, DATES OF EMPLOYMENT OR SALARY.
GS-07: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-05, in the Federal Service.
Specialized experience includes the following (Must meet 2 out of 3 examples):
· Working with health care billing and codes. · Working with medical coding systems. · Responding to oral and written inquiries regarding medical or billing issues.
OR
1 full year of graduate level education
OR
Superior Academic Achievement (more information regarding S.A.A. can be found here under "Application of Qualification Standards).
OR
A combination of education and experience.
GS-09: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-07, in the Federal Service.
Specialized experience includes the following (Must meet 3 out of 4):
· Working with health care billing and codes. · Working with medical coding systems. · Responding to oral and written inquiries regarding medical or billing issues. · Resolving issues or problems of a procedural or factual nature in order to make decisions on medical bills
OR
master's or equivalent graduate degree
OR
2 full years of progressively higher level graduate education leading to such a degree
OR
LL.B. or J.D., if related
OR
A combination of education and experience.
GS-11: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-09, in the Federal Service.
Specialized experience includes the following (Must meet all examples):
· Working with a complex medical authorization and bill payment system. · Ability to answer oral and written inquiries through presentations or trainings on medical or billing issues. · Monitoring medical authorizations and bill payments for overutilization and abuse. · Making recommendations to resolve medical coding and billing issues.
OR
Ph.D. or equivalent doctoral degree
OR
3 full years of progressively higher level graduate education leading to such a degree
OR
LL.M., if related
OR
A combination of education and experience.
Education
Provide transcripts if considering educational substitution.
Any applicant falsely claiming an academic degree from an accredited school will be subject to actions ranging from disqualification from federal employment to removal from federal service.
If your education was completed at a foreign college or university, you must show comparability to education received in accredited educational institutions in the United States and comparability to applicable minimum course work requirements for this position. Click Evaluation of Foreign Education for more information.
Additional information
Persons who are deaf, hard of hearing, blind, or have speech disabilities, please dial 711 to access telecommunications relay services.
DOL seeks to attract and retain a high-performing and diverse workforce in which employees' differences are respected and valued to better meet the varying needs of the diverse customers we serve. DOL fosters a diverse and inclusive work environment that promotes collaboration, flexibility, and fairness so that all individuals are able to participate and contribute to their full potential.
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How you will be evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
If you meet the minimum qualifications, you will be evaluated against the evaluation factors below and will be placed into a category based on your vacancy question responses.
Categories
Category A - Meets the basic qualification requirements for the vacancy and has successful experience in the same or similar job that has demonstrated superior proficiency in applying critical competencies required by this position to work of increased levels of difficulty and complexity.
Category B - Meets the basic qualification requirements for the vacancy and demonstrates satisfactory proficiency in the critical competencies required by this position.
Category C - Meets the specialized experience described in the minimum qualifications requirements section of this announcement and demonstrates proficiency in the basic competencies.
Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:
Technical Knowledge - uses thorough knowledge and understanding of knowledge of claims examiners and management on coding accepted conditions for injured workers and other issues that impact the authorization of medical treatment, payment of benefits and overall cost containment in each case.
Problem Solving - Identifies problems; determines accuracy and relevance of information; uses sound judgment to generate and evaluate alternatives, and to make recommendations.
Written/Oral Communication - Writes in a clear, concise, organized, and convincing manner for the intended audience. Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.
The information you provide on your resume may be verified by a review of your work experience, employment start/end dates/hours worked and/or education, by checking references and through other means (ex. interview). The examining Office of Human Resources (OHR) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your responses to the vacancy questions. If not, the OHR may amend your responses to more accurately reflect the level of competency indicated by the content of your resume. Your evaluation may also include a review by a Human Resources Specialist or panel and may include other assessments (ex. interview, panel review, written test, writing sample, etc.)
INFORMATION FOR ICTAP/CTAP ELIGIBLE(S) ONLY: If you are eligible for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligible(s) who are placed into Category [B] or higher will be considered "well-qualified." Be sure to review DOL Account Eligibility Questions #24 to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation. Click Application of Veterans Preference for Category Rating Jobs for more information.
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. You are not required to submit a document if it does not apply to you. Warning: If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission. Also, do not upload password-protected documents.
- Resumes are required - provide a resume either by creating one in USAJOBS or uploading one from your profile. To receive full consideration for relevant and specialized experience, please list the month, year, and the number of work hours worked for the experience listed on your resume. We also suggest that you preview the vacancy questions, and confirm that your resume supports your question responses.
- Veterans Documents (if applicable): To be considered as a 5-point preference eligible, you must submit a copy of your Certificate of Release or Discharge From Active Duty, DD214. Your DD-214 must show the type of discharge and dates of active duty. To claim 10-point preference, you must submit a copy of your DD214; an Application for 10-point Veteran's Preference, SF15; and the proof of entitlement of this preference which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. (For active duty service members expecting honorable or general discharge or release within 120 days, click Active Duty). Without this documentation, you will not receive veteran's preference. For more information, go to https://www.fedshirevets.gov.
- Displaced Employee Placement Documents – Only required if requesting priority consideration under CTAP or ICTAP eligibility.
- Cover Letters are not mandatory and will not be used to verify experience, but may be submitted. Applicants selected for employment who are not current DOL employees will be required to provide proof of citizenship, and the E-Verify system will be used to confirm the employment eligibility of all new hires.
Unofficial Transcript(s) (in English) - If you are using education as a basis for qualifying for this position, you must submit all applicable academic transcripts demonstrating that you meet the qualifying educational requirements (ex. BA/BS, MA, JD, Ph.D., etc.). If specific coursework is required to qualify, you must supply an unofficial transcript from each academic institution in which the required courses were taken in order to receive credit.
You may upload your unofficial transcript(s) as one document (3 MB size limit). If over 3 MB, please submit via fax feature.
NOTE: The OFFICIAL Transcript(s) MUST BE RECEIVED, if you are selected, and prior to receiving the firm offer with a start date.
Reference the “Education Section” for College Transcript and Evaluation of Foreign Education.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
To apply for this position, you must complete the initial online application, including submission of the required documentation specified in the "Required Documents" section.
Follow the steps below to apply. Your application and ALL required supplemental documents MUST be received by 11:59 pm Eastern Time (ET) on the vacancy closing date to receive consideration. Paper applications and supplemental documents submitted in any other manner without prior approval from the vacancy contact will not be considered. Click here for information on Reasonable Accommodations.
SAVE your information before the 30 MINUTE TIMEOUT! For help, go to USAJOBS Help Center.
STEP 1 - Create USAJOBS Account on www.usajobs.gov, including Resume and Saved Documents Your resume must provide sufficient information to substantiate your responses to the self-assessment vacancy questions. If not, HR may amend your responses to more accurately reflect the competency indicated by resume content. FOR EACH EMPLOYMENT PERIOD, include: start/end month & year and note full-time or part-time (if part-time, include # of hours worked per week); otherwise, your application may be considered incomplete.
STEP 2 - Complete the 1st part of the application process (USAJOBS) Once you have identified a job on USAJOBS that you wish to apply for, click on the title and click the "Apply" button. For questions about the vacancy, contact the Agency Contact at the bottom of the announcement. Click “Start Application” and proceed through the 5 steps noted at the top of the USAJOBS page. You will be able to select a resume and documents from your USAJOBS Account that you can submit as a package as part of your DOL application. At Step 5, click “Continue to Agency Site”.
STEP 3 – Complete the 2nd part of the application process (DOL) On the Department of Labor (DOL) page, create a DOL Account if you have not already and click “APPLY TO THIS VACANCY”. Continue through the 7 progress steps indicated by circles at the top of the DOL page. The 3rd progress step is where you answer the vacancy specific questions. The 4th progress step "Documents" is where you submit required documents (only if applicable to you) specified in the "Required Documents" section of this vacancy. If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission.
STEP 4 – On the “Review and Submit” step, click “Submit Application” The last “Confirmation” step will turn green noting that your application was submitted successfully.
STEP 5 - Edit Application as needed by 11:59 pm ET of Closing Date by returning to USAJOBS, clicking the vacancy, then “Update Application”.
Labor, Ofc of Workers' Compensation Programs
200 Constitution Ave., NW
Washington, District of Columbia 20210
United States
Next steps
Once your complete application is received, we will conduct an evaluation of your qualifications and refer candidates for selection consideration. Candidates will be referred to the hiring manager for further consideration and possible interview. You will be notified of the outcome. A selection is expected to be made within 30 calendar days from the issuance date of the certificate.
For instructions on how to check the status of your application, go to: USAJOBS Help Guide.
USAJOBS will no longer send status alert email notifications. You can check your application status in the TAS by logging into USAJOBS and in the Applicant Dashboard, click the hiring agency Talent Acquisition System (TAS). If the TAS does not provide application tracking information, contact the agency point of contact on the job announcement.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. You are not required to submit a document if it does not apply to you. Warning: If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission. Also, do not upload password-protected documents.
- Resumes are required - provide a resume either by creating one in USAJOBS or uploading one from your profile. To receive full consideration for relevant and specialized experience, please list the month, year, and the number of work hours worked for the experience listed on your resume. We also suggest that you preview the vacancy questions, and confirm that your resume supports your question responses.
- Veterans Documents (if applicable): To be considered as a 5-point preference eligible, you must submit a copy of your Certificate of Release or Discharge From Active Duty, DD214. Your DD-214 must show the type of discharge and dates of active duty. To claim 10-point preference, you must submit a copy of your DD214; an Application for 10-point Veteran's Preference, SF15; and the proof of entitlement of this preference which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. (For active duty service members expecting honorable or general discharge or release within 120 days, click Active Duty). Without this documentation, you will not receive veteran's preference. For more information, go to https://www.fedshirevets.gov.
- Displaced Employee Placement Documents – Only required if requesting priority consideration under CTAP or ICTAP eligibility.
- Cover Letters are not mandatory and will not be used to verify experience, but may be submitted. Applicants selected for employment who are not current DOL employees will be required to provide proof of citizenship, and the E-Verify system will be used to confirm the employment eligibility of all new hires.
Unofficial Transcript(s) (in English) - If you are using education as a basis for qualifying for this position, you must submit all applicable academic transcripts demonstrating that you meet the qualifying educational requirements (ex. BA/BS, MA, JD, Ph.D., etc.). If specific coursework is required to qualify, you must supply an unofficial transcript from each academic institution in which the required courses were taken in order to receive credit.
You may upload your unofficial transcript(s) as one document (3 MB size limit). If over 3 MB, please submit via fax feature.
NOTE: The OFFICIAL Transcript(s) MUST BE RECEIVED, if you are selected, and prior to receiving the firm offer with a start date.
Reference the “Education Section” for College Transcript and Evaluation of Foreign Education.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
To apply for this position, you must complete the initial online application, including submission of the required documentation specified in the "Required Documents" section.
Follow the steps below to apply. Your application and ALL required supplemental documents MUST be received by 11:59 pm Eastern Time (ET) on the vacancy closing date to receive consideration. Paper applications and supplemental documents submitted in any other manner without prior approval from the vacancy contact will not be considered. Click here for information on Reasonable Accommodations.
SAVE your information before the 30 MINUTE TIMEOUT! For help, go to USAJOBS Help Center.
STEP 1 - Create USAJOBS Account on www.usajobs.gov, including Resume and Saved Documents Your resume must provide sufficient information to substantiate your responses to the self-assessment vacancy questions. If not, HR may amend your responses to more accurately reflect the competency indicated by resume content. FOR EACH EMPLOYMENT PERIOD, include: start/end month & year and note full-time or part-time (if part-time, include # of hours worked per week); otherwise, your application may be considered incomplete.
STEP 2 - Complete the 1st part of the application process (USAJOBS) Once you have identified a job on USAJOBS that you wish to apply for, click on the title and click the "Apply" button. For questions about the vacancy, contact the Agency Contact at the bottom of the announcement. Click “Start Application” and proceed through the 5 steps noted at the top of the USAJOBS page. You will be able to select a resume and documents from your USAJOBS Account that you can submit as a package as part of your DOL application. At Step 5, click “Continue to Agency Site”.
STEP 3 – Complete the 2nd part of the application process (DOL) On the Department of Labor (DOL) page, create a DOL Account if you have not already and click “APPLY TO THIS VACANCY”. Continue through the 7 progress steps indicated by circles at the top of the DOL page. The 3rd progress step is where you answer the vacancy specific questions. The 4th progress step "Documents" is where you submit required documents (only if applicable to you) specified in the "Required Documents" section of this vacancy. If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission.
STEP 4 – On the “Review and Submit” step, click “Submit Application” The last “Confirmation” step will turn green noting that your application was submitted successfully.
STEP 5 - Edit Application as needed by 11:59 pm ET of Closing Date by returning to USAJOBS, clicking the vacancy, then “Update Application”.
Labor, Ofc of Workers' Compensation Programs
200 Constitution Ave., NW
Washington, District of Columbia 20210
United States
Next steps
Once your complete application is received, we will conduct an evaluation of your qualifications and refer candidates for selection consideration. Candidates will be referred to the hiring manager for further consideration and possible interview. You will be notified of the outcome. A selection is expected to be made within 30 calendar days from the issuance date of the certificate.
For instructions on how to check the status of your application, go to: USAJOBS Help Guide.
USAJOBS will no longer send status alert email notifications. You can check your application status in the TAS by logging into USAJOBS and in the Applicant Dashboard, click the hiring agency Talent Acquisition System (TAS). If the TAS does not provide application tracking information, contact the agency point of contact on the job announcement.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
