About the Position: This position is located at Defense Health Network Pacific Rim, San Diego, CA Directorate of RM Financial Management.
The incumbent is responsible for performing duties as assigned which assist in solving difficult and complex problems in the areas of Medical Services Account (MSA), Third Party Collection (TPC), Medical Affirmative Claims (MAC), Elective Cosmetic Surgery (ECS) and Inter-Agency Billing (IAB) programs.
This is a Direct Hire Solicitation
Summary
About the Position: This position is located at Defense Health Network Pacific Rim, San Diego, CA Directorate of RM Financial Management.
The incumbent is responsible for performing duties as assigned which assist in solving difficult and complex problems in the areas of Medical Services Account (MSA), Third Party Collection (TPC), Medical Affirmative Claims (MAC), Elective Cosmetic Surgery (ECS) and Inter-Agency Billing (IAB) programs.
Analyzes and performs work necessary to accomplish work processes by using numerous manual and automation systems and software programs necessary for billing operations.
Compares account balances in various financial and billing information systems with related data to assure agreement.
Utilizes a thorough knowledge of medical terminology and disease processes to analyze each record of treatment to ascertain which visits are related to the claim in question.
Identifies sources of reimbursable earnings and ensuring accurate billing, collecting, depositing and reporting of these earnings.
Responsible for daily operation for all aspects of reimbursable account management assuring that billing and collection procedures comply with policies and procedures directed by higher authority.
Receive daily encounter forms or computer downloads from all clinical services reflecting care patient received. Review each encounter for consistency, accuracy, and completeness of data.
Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment.
This position has been designated "Mission Essential". In the event of severe weather conditions or other such emergency type situations the incumbent is required to report to work or remain at work as scheduled to support mission operations.
Appointment to this position is subject to a one-year probationary period unless the appointee has previously met the requirements as described in 5 CFR Part 315.
Employees assigned to a medical treatment facility are required to be screened for applicable immunizations or pre-existing immunity based on occupational risk, regardless of job series.
This position has a mandatory seasonal influenza vaccination requirement and is subject to annual vaccination.
This is A FINANCIAL MANAGEMENT Level 1 Certified position. Failure to obtain this certification within the required time may subject the incumbent to adverse action.
Qualifications
Who May Apply: US Citizens
In order to qualify, you must meet the education requirements described below. 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; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.
Specialized Experience: One year of specialized experience which includes: (1) generating health insurance claims to third party payers and/or responsible parties; and (2) utilizing automation systems to retrieve health insurance information and (3) re-billing or correcting billing of accounts previously submitted. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05).
Education
Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.
Additional information
Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
You will be required to provide proof of U.S. Citizenship.
One year trial/probationary period may be required.
Direct Deposit of Pay is required.
Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
Multiple positions may be filled from this announcement.
Salary includes applicable locality pay or Local Market Supplement.
If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.
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.
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.
Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement. Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.
If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position.
Veterans and Military Spouses will be considered along with all other candidates.
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 documents you are required to submit vary based on whether or not you are eligible for preference in federal employment. A complete description of preference categories and the associated required documents is in the Applicant Checklist for Public Announcements.
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1. Your resume:
Your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration.
For each relevant work experience, make sure you include the employer's name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement. If your resume does not contain this information, your application may be marked as incomplete, and you may not receive consideration for this position.
Use plain language. Avoid using acronyms and terms that are not easily understood. The hiring agency will not make assumptions about what's in your resume.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations, and you may not be considered for this vacancy.
License/Certification: This position requires a job-related license or certification. THIS IS A FINANCIAL MANAGEMENT Level 1 Certified position designated as such in accordance with the National Defense Authorization Act (NDAA) 2012, Public Law 112-81, Subtitle F-Financial Management, section 1051, amending 10 United States Code, section 1599d. Incumbent of this position is required to comply with all Department of Defense requirements of this certification program. This certification requirement is a condition of employment for this position. Failure to obtain this certification within the required time may subject the incumbent to adverse action.
NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
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 online questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 04/03/2026to receive consideration.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/12923455).
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. As a reminder, your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration. For additional information, refer to the 'Required Documents' section.
You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. Your resume selected in USAJOBS will be included, but you must re-select other documents from your USAJOBS account or your application may be incomplete.
It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
JT-DD83DZ PAC RIM DHN - SAN DIEGO
DO NOT USE
San Diego, CA 92134
US
Next steps
If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
The documents you are required to submit vary based on whether or not you are eligible for preference in federal employment. A complete description of preference categories and the associated required documents is in the Applicant Checklist for Public Announcements.
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1. Your resume:
Your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration.
For each relevant work experience, make sure you include the employer's name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement. If your resume does not contain this information, your application may be marked as incomplete, and you may not receive consideration for this position.
Use plain language. Avoid using acronyms and terms that are not easily understood. The hiring agency will not make assumptions about what's in your resume.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations, and you may not be considered for this vacancy.
License/Certification: This position requires a job-related license or certification. THIS IS A FINANCIAL MANAGEMENT Level 1 Certified position designated as such in accordance with the National Defense Authorization Act (NDAA) 2012, Public Law 112-81, Subtitle F-Financial Management, section 1051, amending 10 United States Code, section 1599d. Incumbent of this position is required to comply with all Department of Defense requirements of this certification program. This certification requirement is a condition of employment for this position. Failure to obtain this certification within the required time may subject the incumbent to adverse action.
NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
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 online questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 04/03/2026to receive consideration.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/12923455).
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. As a reminder, your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration. For additional information, refer to the 'Required Documents' section.
You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. Your resume selected in USAJOBS will be included, but you must re-select other documents from your USAJOBS account or your application may be incomplete.
It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
JT-DD83DZ PAC RIM DHN - SAN DIEGO
DO NOT USE
San Diego, CA 92134
US
Next steps
If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
