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***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:

• Validating claims for billing purposes ensuring eligibility and referring questionable coding for review.
• Submitting claims to third party health insurance carriers, with knowledge of Medicare coverage benefits.
• Interpreting third party insurance policies and requirements for billing.
• Taking responsibility for Medicare reimbursable billing activities.
• Following instructions about timeliness, objectives, and relative priorities for doing work.
• Handling conflicting goals, objectives, priorities, timelines, and deadlines.
• Exhibiting flexibility in adapting to changing demands within specific timelines.
• Accepting and completing work provided by a standardized control system such as batched work, caseload level, or other defined structure.
• Using a wide range of office software applications such as Microsoft Access, Excel, and Word.
• Composing correspondence on a situational basis.
• Processing billings using ICD-9-MC, CPT/4, and HCPCS codes timely.
• Performing other duties assigned as it relates to the position.

Conditions of employment

• You must be a U.S. Citizen to apply for this job
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to background/security investigation
• Selected applicants will be required to complete an online onboarding process
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

Qualifications

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; verifying claims for billing purposes ensuring eligibility and referring questionable coding for review and interprets insurance policies and requirements for billing. (Resume(s) must clearly demonstrate the experience to be creditable. We will not make assumptions regarding experience.)

You will be rated on the following Competencies as part of the assessment questionnaire for this position:

• Customer Service (Clerical/Technical)
• Decision Making
• Manages and Organizes Information
• Self-Management
• Technical Competence

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. If your resume does not support your questionnaire answers, we will not allow credit for your response(s).

Your responses to the assessment questionnaire will be reviewed along with the information provided in your resume and supporting documentation to determine if you are qualified for the position. If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your rating may be lowered and/or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

Candidates who apply under All U.S. Citizens announcements will be rated and ranked using Category Rating procedures. Qualified candidates will be assigned to a quality category. The categories are defined as follows:

• Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position;
• Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job;
• Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
• Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.