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.
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.
Current federal employees with competitive status; CTAP/ICTAP eligibles; VEOA eligibles; Military Spouse eligibles; Land and Base Management Act eligibles Also advertised as job #DE-23-PHIL-OWCP-12027083-MS for non-status applicants; to be considered for each, apply to BOTH jobs.
Duties Include but are not limited to:
-Serve as a senior specialist on all aspects of a complex medical coding system and the interpretation of healthcare standardized codes
-Provide 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.
-Actively participate and contribute to team projects in area of expertise. Perform factfinding to spot trends of systemic problems; conduct analysis to resolve and correct any negative elements within the bill payment and medical authorization process; and report unresolved system or policy issues to team leaders and management for appropriate action.
-Serve as a technical specialist on medical bill processing systems, which include all OWCP systems and its contractors to process bills and determine appropriate medical authorization.
-Participate in conducting review and analysis of DFELHWC medical coding processes. Coordinates, implements, and monitors utilization reviews of bill payment processes. Conduct reviews of rejected bills to ensure appropriate processing.
Requires a probationary period if the requirement has not been met.
Appointment to this position may require a background investigation
Qualifications
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. POSITION TITLES ALONE CANNOT BE USED TO DETERMINE IF YOU ARE QUALIFIED. PLEASE LIST DATES IN MM/DD/YYYY FORMAT. THIS IS IMPERATIVE IN DETERMINING IF WHETHER YOU HAVE AT LEAST 1 YEAR OF CREDITABLE SPECIALIZED EXPERIENCE. DATES WILL NOT BE ASSUMED.
Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, 11. Specialized experience includes knowledge to do the following:
-Accurately code all aspects of a complex medical coding system
-Review, resolve, and audit billing problems
-Monitor payments for over utilization and abuse; and
-Make recommendations to resolve medical coding and billing issues
Education
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 coursework requirements for this position. Click Evaluation of Foreign Education for more information.
Additional information
This position is inside the bargaining unit. If the duty location is within the Washington, D.C. metropolitan area, the position will be included in the Local 12, AFGE bargaining unit. If the duty location is outside the Washington, D.C. metropolitan area, the position will be included in the NCFLL bargaining unit.
Persons who are deaf, hard of hearing, blind, or have speech disabilities, please dial 711 to access telecommunications relay services.
The mission of the Department of Labor (DOL) is to protect the welfare of workers and job seekers, improve working conditions, expand high-quality employment opportunities, and assure work-related benefits and rights for all workers. As such, the Department is committed to fostering a workplace and workforce that promote equal employment opportunity, reflects the diversity of the people we seek to serve, and models a culture of respect, equity, inclusion, and accessibility where every employee feels heard, supported, and empowered.
Applicants must meet the eligibility requirements of time-in-grade (52 weeks at the next lower grade), time-after-competitive-appointment (90 days), and minimum qualifications (52 weeks equivalent to the next lower grade in federal service). These requirements must be met within 30 days of 07/13/2023, the announcement closing date.
Please Note: Your SF-50 must include enough information to be able to determine that time-in-grade requirements have been met and reflect your position title, pay plan/series/grade, tenure, and the type of appointment (i.e. competitive/excepted). In some cases, you may need to submit more than one SF-50.
Full Promotion Potential: This position is at the Full-Performance Level (FPL).
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.
Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:
The information you provide may be verified by a review of your paid, unpaid, volunteer, and other lived experience, as it demonstrates the competencies or skills required for the position to be filled. Your evaluation may include an interview, reference checks, or other assessment conducted by HR specialists, subject matter experts, or panel members and may include other assessment tools (ex. interview, structured interview, written test, work sample, etc.). The examining Office of Human Resources (OHR) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your vacancy question responses. If not, the OHR may amend your responses to more accurately reflect the level of competency indicated by the content of your resume.
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) will be considered "well-qualified" if they attain at least a rating score of 85 in a numerical rating scheme. Be sure to review the eligibility questions to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation.
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. 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.
The following documents are required from all applicants (PLEASE READ CAREFULLY):
ARE YOU A CURRENT OR FORMER FEDERAL EMPLOYEE? If applying as a status candidate with current or former Federal Service, please provide a copy of your last or most recent SF-50, "Notification of Personnel Action" which shows your appointment eligibility for the position for which you are applying. Your SF-50 must identify the highest grade you held on a permanent basis, Pay Plan/Pay Schedule, Series, and Grade/Pay Band, and career status. Multiple SF-50 may be submitted to demonstrate your highest previous rate and eligibility.
*WARNING: An award SF-50 (ex. cash or time off award) may not indicate grade, step, and competitive status. For current DOL employees, an award SF-50 DOES NOT indicate grade and step.
Resumes are required - provide a resume either by creating one in USAJOBS or uploading one from your computer and USAJOBS profile. To receive full consideration for relevant and specialized experience, please list the month, year, and 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.
Most recent performance appraisal/evaluation signed and dated within 18 months is requested by the agency but will not disqualify candidates if not submitted. If not submitted during the application process, one may/will be requested at the time of the interview if the opportunity is extended. *In most cases, ICTAP/CTAP applicants must submit this document - please see ICTAP/CTAP links below for more details.
The following documents are required if applicable:
Displaced Employee Placement Documents - Only required if requesting priority consideration under Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) Eligibility. Click/Review these ICTAP/CTAP links to confirm what must be submitted as proof that the requirement has been met.
DD-214 - verifying military service, eligibility for consideration under the Veterans Employment Opportunity Act (VEOA), and showing the character of discharge (ex. Member Copy 4 and 2 are acceptable vs. Copy 1 which is not acceptable to adjudicate veteran's preference)
Applicants who are eligible for consideration, and wish to be considered, under one of the following non-competitive hiring authorities must submit appropriate documentation (click on the links below to see the documentation requirements): (a) Military Spouses (MISP) (b) Other
Land Management Eligible(s): a copy of your most recent Notification of Personnel Action (SF-50 or equivalent) proving your eligibility for appointment under the Land Management Workforce Flexibility Act. This service must have been performed in competitive service, under a time-limited appointment in a Land Management Agency, as defined by P.L. 114-328. For more information, click here.
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.
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 a USAJOBS Account on www.usajobs.gov, including your 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 www.usajobs.gov 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. In 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 the 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.
STEP5 - Edit Application as needed by 11:59 pm ET of the Closing Date by returning to USAJOBS, clicking the vacancy, then "Update Application."
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
Office of Workers Compensation Programs
200 Constitution Avenue NW
Washington, DC 20210
US
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 interviews. You will be notified of the outcome. A selection is expected to be made within 30 calendar days of 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's point of contact on the job announcement.
To verify your application is complete, log into your USAJOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link, and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USAJOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
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. 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.
The following documents are required from all applicants (PLEASE READ CAREFULLY):
ARE YOU A CURRENT OR FORMER FEDERAL EMPLOYEE? If applying as a status candidate with current or former Federal Service, please provide a copy of your last or most recent SF-50, "Notification of Personnel Action" which shows your appointment eligibility for the position for which you are applying. Your SF-50 must identify the highest grade you held on a permanent basis, Pay Plan/Pay Schedule, Series, and Grade/Pay Band, and career status. Multiple SF-50 may be submitted to demonstrate your highest previous rate and eligibility.
*WARNING: An award SF-50 (ex. cash or time off award) may not indicate grade, step, and competitive status. For current DOL employees, an award SF-50 DOES NOT indicate grade and step.
Resumes are required - provide a resume either by creating one in USAJOBS or uploading one from your computer and USAJOBS profile. To receive full consideration for relevant and specialized experience, please list the month, year, and 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.
Most recent performance appraisal/evaluation signed and dated within 18 months is requested by the agency but will not disqualify candidates if not submitted. If not submitted during the application process, one may/will be requested at the time of the interview if the opportunity is extended. *In most cases, ICTAP/CTAP applicants must submit this document - please see ICTAP/CTAP links below for more details.
The following documents are required if applicable:
Displaced Employee Placement Documents - Only required if requesting priority consideration under Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) Eligibility. Click/Review these ICTAP/CTAP links to confirm what must be submitted as proof that the requirement has been met.
DD-214 - verifying military service, eligibility for consideration under the Veterans Employment Opportunity Act (VEOA), and showing the character of discharge (ex. Member Copy 4 and 2 are acceptable vs. Copy 1 which is not acceptable to adjudicate veteran's preference)
Applicants who are eligible for consideration, and wish to be considered, under one of the following non-competitive hiring authorities must submit appropriate documentation (click on the links below to see the documentation requirements): (a) Military Spouses (MISP) (b) Other
Land Management Eligible(s): a copy of your most recent Notification of Personnel Action (SF-50 or equivalent) proving your eligibility for appointment under the Land Management Workforce Flexibility Act. This service must have been performed in competitive service, under a time-limited appointment in a Land Management Agency, as defined by P.L. 114-328. For more information, click here.
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.
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 a USAJOBS Account on www.usajobs.gov, including your 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 www.usajobs.gov 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. In 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 the 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.
STEP5 - Edit Application as needed by 11:59 pm ET of the Closing Date by returning to USAJOBS, clicking the vacancy, then "Update Application."
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
Office of Workers Compensation Programs
200 Constitution Avenue NW
Washington, DC 20210
US
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 interviews. You will be notified of the outcome. A selection is expected to be made within 30 calendar days of 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's point of contact on the job announcement.
To verify your application is complete, log into your USAJOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link, and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USAJOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
