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Medical Reimbursement Technician

Department of Veterans Affairs
Veterans Health Administration
Veterans Health Administration
This job announcement has closed

Summary

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.

Overview

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Reviewing applications
Open & closing dates
10/24/2025 to 11/06/2025
Salary
$40,332 to - $58,445 per year
Pay scale & grade
GS 5 - 6
Location
17 vacancies in the following location:
Middleton, WI
Remote job
No
Telework eligible
No
Travel Required
Not required
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
6
Supervisory status
No
Security clearance
Other
Drug test
No
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
Financial disclosure
No
Bargaining unit status
No
Announcement number
CARZ-12820931-26-DC
Control number
848715700

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Duties

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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***

NOTE: This announcement has been extended to close on November 6, 2025. Applicant(s) who previously applied, do not need to re-apply.

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

Requirements

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Conditions of employment

  • You must be a U.S. Citizen to apply for this job
  • To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.
  • Selective Service Registration is required for males born after 12/31/1959
  • Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required.
  • 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) - See "Required Documents" below for details.
As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.
Upon completion of your probationary, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

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; 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/.

Education


IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

There is no educational substitution at the GS 6 grade level.

NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Additional information

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.

Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

This job opportunity announcement may be used to fill additional vacancies.

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 80 or more before any Veterans preference points) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.

Note: Per "Executive Order 14251: Exclusions from Federal Labor-Management Relations Programs", this position is no longer eligible for bargaining unit participation.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

How you will be evaluated

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

Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Arithmetic/Mathematical Reasoning
  • Customer Service
  • Customer Service (Clerical/Technical)
  • Decision Making
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Manages and Organizes Information
  • Reasoning
  • Self-Management
  • Teamwork
  • Technical Competence


Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.

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 the type and quality of experience that substantially exceeds the minimum qualifications
  • Very Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a very considerable extent, the minimum qualifications
  • Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a considerable extent, the minimum qualifications
  • Well qualified - Applicants possessing the type and quality of experience that marginally exceeds the minimum qualifications of the position and who demonstrate average proficiency in most of the critical competencies
  • Qualified - Applicants possessing the type and quality of experience that meets the minimum qualifications
Application of Veterans' Preference: Category rating and selection procedures place those with veteran's preference above non-preference eligibles within each category. Preference eligible applicants that meet the eligibility and qualification requirements and who have a compensable service-connected disability of at least 10 percent are listed in the highest quality category (except when the position being filled is scientific or professional at the GS-09 grade level or higher).

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

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