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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***

Duties will include, but are not limited to the following:

• 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.

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. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)

Qualifications

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.

Specialized Experience (GS-5): At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-4) that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician. Specialized experience includes follows instructions about timeliness, objectives, and relative priorities for doing administrative work; communicates with other staff as necessary to discuss administrative concerns; and reviews and determine the appropriateness of administrative data.

~OR~

Education: 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. NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation.

~OR~

Combination: 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. NOTE: If you select this option, you must submit a copy of your transcript with your application. Education cannot be credited without documentation.

Specialized Experience: (GS-6) At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-5) that has given you the knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician. Specialized experience includes: follows instructions about timeliness, objectives and relative priorities for doing administrative work; communicates with other staff as necessary to discuss administrative concerns; and reviews and determines the appropriateness of administrative data; validates claims for billing purposes ensuring eligibility and referring questionable coding for review; and Interprets insurance policies and requirements for billing.

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.