- Position Title
- Reimbursable Billing Technician
- Agency
- Veterans Health Administration
- Announcement Number
- CBZY-12619429-25-MB Opens in new window
- Open Period
- Thursday, November 21, 2024 to Wednesday, December 4, 2024
For preview purposes only. To apply, please return to the USAJOBS announcement and click the Apply button.
Eligibilities
1.
Do you claim Veterans’ Preference?
2.
Are you currently employed by the Department of Veterans Affairs?
This includes: Career/Career Conditional or Excepted Service (i.e. Canteen, Hybrid, Title 38, etc. and meets interchange agreement requirements). This does not include temporary, term or temporary intermittent.
To verify your eligibility, you must submit a copy of your most recent Notification of Personnel Action, Standard Form 50 (SF-50). Your SF-50 must include enough information to be able to determine that time-in-grade requirements have been met (if applicable) and include your position title, pay plan/series/grade, tenure and the type of appointment (i.e. Competitive or Excepted). Please be aware that award SF-50's do not always include this pertinent information.
This includes: Career/Career Conditional or Excepted Service (i.e. Canteen, Hybrid, Title 38, etc. and meets interchange agreement requirements). This does not include temporary, term or temporary intermittent.
To verify your eligibility, you must submit a copy of your most recent Notification of Personnel Action, Standard Form 50 (SF-50). Your SF-50 must include enough information to be able to determine that time-in-grade requirements have been met (if applicable) and include your position title, pay plan/series/grade, tenure and the type of appointment (i.e. Competitive or Excepted). Please be aware that award SF-50's do not always include this pertinent information.
3.
Are you a former employee of the Department of Veterans Affairs who:
• formerly occupied a career or career conditional position at the VA within the preceding two years before applying for reemployment at VA; AND,
• voluntarily departed such position, or was subject to a reduction in force, and had a satisfactory performance record while occupying such position; AND,
• since departing VA has maintained licensing requirements, related to the position, if any, and gained skills, knowledge, or other factors related to the position; AND,
• possesses at least one year of specialized experience equivalent to the next lower grade level of the position sought?
Appointment under this authority is exempt from competitive examining procedures and Veteran's preference.
To verify your eligibility, you must provide a copy of your latest Notification of Personnel Action, Standard Form 50 that demonstrates you meet the requirements outlined in P.L. 115-46, VA Choice and Quality Employment Act of 2017, section 204.
• formerly occupied a career or career conditional position at the VA within the preceding two years before applying for reemployment at VA; AND,
• voluntarily departed such position, or was subject to a reduction in force, and had a satisfactory performance record while occupying such position; AND,
• since departing VA has maintained licensing requirements, related to the position, if any, and gained skills, knowledge, or other factors related to the position; AND,
• possesses at least one year of specialized experience equivalent to the next lower grade level of the position sought?
Appointment under this authority is exempt from competitive examining procedures and Veteran's preference.
To verify your eligibility, you must provide a copy of your latest Notification of Personnel Action, Standard Form 50 that demonstrates you meet the requirements outlined in P.L. 115-46, VA Choice and Quality Employment Act of 2017, section 204.
4.
Are you a veteran who separated from active duty under honorable conditions AND you:
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service. You must also submit the disability letter from the Department of Veterans Affairs or Armed Service and the Application for 10-Point Veteran Preference, Standard Form 15.
- have a rating by the Department of Veterans Affairs showing a compensable service-connected disability of 30% or more; OR,
- retired from active military service with a service-connected disability rating of 30% or more?
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service. You must also submit the disability letter from the Department of Veterans Affairs or Armed Service and the Application for 10-Point Veteran Preference, Standard Form 15.
5.
Were you employed overseas as an Appropriated Fund employee AND did you:
For more information, review USAJOBS Former Overseas Employees resources.
To verify your eligibility, you must submit a copy of your latest Notification of Personnel Action, Standard Form 50, and performance appraisal.
- complete 52 weeks of creditable overseas service in an appropriated fund position(s) as a family member during the time you accompanied a sponsor officially assigned to an oversea area; AND,
- receive a fully successful or better (or equivalent) performance rating: AND,
- return to the United States to resume residence less than 3 years ago?
For more information, review USAJOBS Former Overseas Employees resources.
To verify your eligibility, you must submit a copy of your latest Notification of Personnel Action, Standard Form 50, and performance appraisal.
6.
1. Are you the spouse of a member of the Armed Forces? (Includes all spouses of members of the armed forces on active duty. Spouses do not have to relocate with active duty service member) To verify your eligibility, submit: (1) Copy of your marriage license. (2) Proof of service members active duty status.
-OR-
2. Are you the spouse of a service member who:
-OR-
3. Are you the spouse of a deceased service member who:
-OR-
2. Are you the spouse of a service member who:
- is retired, released, or discharged from the Armed Forces due to a service-connected injury; AND
- on the date on which the member retires, is released, or is discharged, has a disability rating of 100 percent under the standard schedule of rating disabilities in use by the Department of Veterans Affairs;
-OR-
3. Are you the spouse of a deceased service member who:
- was married to the service member on the date the service member died, while on active duty in the Armed Forces; AND
- has not remarried.
To verify your eligibility, submit: (1) a copy of your marriage license, documentation identifying marital status at the time of death and proof that you have not remarried. (2) DD-214 documenting the death of the service member while on active duty, the death certificate; or a letter from the Department of Veterans Affairs or Armed Service, etc. specifying the service member's death while on active duty.
For more information, review USAJOBS Military Spouses resources
Note: The National Defense Authorization Act for Fiscal Year 2019 (NDAA FY19), section 573(e) sunsets these statutory changes on August 12, 2023, after which time the provisions at 5 USC 3330(d) in effect prior to the date of enactment (i.e., August 12, 2018) will apply again.
7.
Are you a current or former federal employee displaced from the agency hiring for this position? If yes, confirm:
For more information, review the USAJOBS Help Center.
To verify your eligibility, you must submit supporting documentation such as a Reduction in Force (RIF) separation notice or a Proposed Removal/Separation notice to include your latest performance rating (if the notice does not have this information included, you must submit a copy of your most recent performance appraisal) and a copy of your latest Notification of Personnel Action, Standard Form 50.
- you are located in the same local commuting area of the vacancy; AND,
- you are applying to a position that is at or below the grade level of the position from which you were or will be separated; AND,
- your grade is equivalent to or below the grade level of the vacancy; AND,
- your last performance rating of record is at least fully successful or the equivalent.
For more information, review the USAJOBS Help Center.
To verify your eligibility, you must submit supporting documentation such as a Reduction in Force (RIF) separation notice or a Proposed Removal/Separation notice to include your latest performance rating (if the notice does not have this information included, you must submit a copy of your most recent performance appraisal) and a copy of your latest Notification of Personnel Action, Standard Form 50.
8.
Have you completed at least 1 year of continuous service immediately before separation from one or more nontemporary Foreign Service appointments; AND, your separation from a Foreign Service career-type appointment occurred in the last 3 years (individuals entitled to veteran's preference do not need to meet this 3-year requirement)?
-OR-
Have you completed at least 3 years of substantially continuous service under one or more nontemporary appointments in the Foreign Service immediately before separation from an unlimited, career-type appointment in that Service?
-OR-
Are you a current or former limited non-career appointee with the Foreign Service and have at least 48 months of continuous service, a performance rating of satisfactory or better, and if a former employee, no more than a one year break in service since your qualifying appointment?
To verify your eligibility, you must submit a copy of your Notification of Personnel Action, Standard Form 50 (SF-50) reflecting your nontemporary status. If you are outside of the 3-year requirement but are entitled to veteran's preference, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service.
-OR-
Have you completed at least 3 years of substantially continuous service under one or more nontemporary appointments in the Foreign Service immediately before separation from an unlimited, career-type appointment in that Service?
-OR-
Are you a current or former limited non-career appointee with the Foreign Service and have at least 48 months of continuous service, a performance rating of satisfactory or better, and if a former employee, no more than a one year break in service since your qualifying appointment?
To verify your eligibility, you must submit a copy of your Notification of Personnel Action, Standard Form 50 (SF-50) reflecting your nontemporary status. If you are outside of the 3-year requirement but are entitled to veteran's preference, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service.
9.
Are you a current or former federal employee displaced from a position in a federal agency other than the Department of Veterans Affairs? If yes, confirm:
To verify your eligibility, you must submit supporting documentation such as a Reduction in Force (RIF) separation notice to include your latest performance rating (if the notice does not have this information included, you must submit a copy of your most recent performance appraisal) and a copy of your latest Notification of Personnel Action, Standard Form 50.
- you are located in the same local commuting area of the vacancy; AND,
- you are applying to a position that is at or below the grade level of the position from which you were or will be separated; AND,
- you are applying to a position that does not have greater promotion potential than the position from which you were or will be separated; AND,
- your last performance rating of record is at least fully successful or the equivalent.
To verify your eligibility, you must submit supporting documentation such as a Reduction in Force (RIF) separation notice to include your latest performance rating (if the notice does not have this information included, you must submit a copy of your most recent performance appraisal) and a copy of your latest Notification of Personnel Action, Standard Form 50.
10.
Are you a current or former employee of a land management agency (Forest Service; Bureau of Land Management; National Park Service; Fish and Wildlife Service; Bureau of Indian Affairs; or Bureau of Reclamation) who:
• was originally hired to a time-limited position under a competitive appointment; AND,
• served one or more time-limited appointments at a land management agency for a period totaling more than 24 months without a break in service of two or more years; AND,
• performed at an acceptable level of service during each period of service; AND,
• if no longer employed by the land management agency, have been separated for no more than two years, and departed that position in good standing?
To verify your eligibility, you must provide a copy of your latest Notification of Personnel Action, Standard Form 50 (SF-50) and performance appraisal that demonstrates you meet the requirements outlined in the 5 U.S.C. 9602.
• was originally hired to a time-limited position under a competitive appointment; AND,
• served one or more time-limited appointments at a land management agency for a period totaling more than 24 months without a break in service of two or more years; AND,
• performed at an acceptable level of service during each period of service; AND,
• if no longer employed by the land management agency, have been separated for no more than two years, and departed that position in good standing?
To verify your eligibility, you must provide a copy of your latest Notification of Personnel Action, Standard Form 50 (SF-50) and performance appraisal that demonstrates you meet the requirements outlined in the 5 U.S.C. 9602.
11.
Are you a former Peace Corps volunteer or VISTA member who has completed your service within the past twelve months?
-OR-
Are you a former Peace Corps volunteer or VISTA member who has completed your service within the past 36 months and is requesting an extension of your non-competitive eligibility due to your military service, status as a full-time student or other experience related to this position?
-OR-
Are you a current or former Peace Corps employee who has completed at least 36 months of continuous service and has been separated from the Peace Corps for less than three years?
To verify your eligibility, you must submit a copy of your description of service or other proof of non-competitive eligibility. If you are a former Peace Corps volunteer or VISTA member who is requesting an extension of your non-competitive eligibility, please also provide the necessary documentation to support your request.
-OR-
Are you a former Peace Corps volunteer or VISTA member who has completed your service within the past 36 months and is requesting an extension of your non-competitive eligibility due to your military service, status as a full-time student or other experience related to this position?
-OR-
Are you a current or former Peace Corps employee who has completed at least 36 months of continuous service and has been separated from the Peace Corps for less than three years?
To verify your eligibility, you must submit a copy of your description of service or other proof of non-competitive eligibility. If you are a former Peace Corps volunteer or VISTA member who is requesting an extension of your non-competitive eligibility, please also provide the necessary documentation to support your request.
12.
Are you a current Federal employee in the excepted service in an agency covered by an Interchange Agreement with at least one year of service in that position?
For more information, review Interchange Agreements with Other Merit Systems.
-OR-
Are you a current:
• Postal Career Service Employee;
• Postal Rate Commission Employee;
• Government Accountability Office (GAO) Employee; or,
• Administrative Office of the U.S. Courts Employee?
For more information, review Miscellaneous Authorities Not Regulated By U.S. Office of Personnel Management.
To verify your eligibility, you must submit a copy of your Notification of Personnel Action, Standard Form (SF-50) reflecting your status.
For more information, review Interchange Agreements with Other Merit Systems.
-OR-
Are you a current:
• Postal Career Service Employee;
• Postal Rate Commission Employee;
• Government Accountability Office (GAO) Employee; or,
• Administrative Office of the U.S. Courts Employee?
For more information, review Miscellaneous Authorities Not Regulated By U.S. Office of Personnel Management.
To verify your eligibility, you must submit a copy of your Notification of Personnel Action, Standard Form (SF-50) reflecting your status.
13.
Do you have an intellectual disability, severe physical disability, or psychiatric disability that qualifies you for Schedule A Disability appointments?
For more information, review USAJOBS Individuals with Disabilities resources.
To verify your eligibility, you must provide appropriate medical documentation, i.e., a letter signed by a licensed medical professional or licensed vocational rehabilitation specialist, certifying your documented disability and eligibility under Schedule A.
For more information, review USAJOBS Individuals with Disabilities resources.
To verify your eligibility, you must provide appropriate medical documentation, i.e., a letter signed by a licensed medical professional or licensed vocational rehabilitation specialist, certifying your documented disability and eligibility under Schedule A.
14.
Do you have prior Career or Career-Conditional Service with the Federal Government? If so, you may be eligible for reinstatement.
To verify your eligibility, you must submit a copy of your separation Notification of Personnel Action, Standard Form 50 (SF-50) or equivalent personnel action form reflecting your permanent, competitive status. Your separation SF-50 (or equivalent personnel action form) must reflect:
To verify your eligibility, you must submit a copy of your separation Notification of Personnel Action, Standard Form 50 (SF-50) or equivalent personnel action form reflecting your permanent, competitive status. Your separation SF-50 (or equivalent personnel action form) must reflect:
- career or career-conditional (Tenure field box 24. is 1 or 2); AND,
- your status in the competitive service (Position Occupied field box 34. is 1).
- highest grade previously held (Grade or Level field box 18.)
15.
Are you currently employed as a civilian employee in the competitive service in a federal agency other than the Department of Veterans Affairs?
To verify your eligibility, you must submit a copy of your latest Notification of Personnel Action, Standard Form 50 (SF-50) or equivalent personnel action form reflecting your permanent, competitive status. Your SF-50 (or equivalent personnel action form) must reflect:
- career or career-conditional (Tenure field is 1 or 2); AND,
- your status is in the competitive service (Position Occupied field is 1)
16.
Are you a veteran whose latest discharge was under honorable conditions spouse, widow/widower, or parent of a veteran, AND you:
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of service which includes character of service. If applying as a spouse, widow/widower, or parent of a veteran eligible for derived preference you must provide acceptable documentation of your preference eligibility as outlined on the SF-15 form. *Note current Federal employees must also meet Time-in-Grade requirements.
- served three or more years of continuous active duty service in the military (NOTE: if released shortly before completing a 3-year tour, you are considered to meet the eligibility); OR,
- are entitled to veterans' preference; OR,
- are eligible for derived preference as a spouse, widow/widower, or parent of a veteran?
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of service which includes character of service. If applying as a spouse, widow/widower, or parent of a veteran eligible for derived preference you must provide acceptable documentation of your preference eligibility as outlined on the SF-15 form. *Note current Federal employees must also meet Time-in-Grade requirements.
17.
Are you a veteran who separated from active duty under honorable conditions AND you:
For more information, review USAJOBS Veterans resources.
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service. If claiming disability preference, you must also submit the disability letter from the Department of Veterans Affairs or Armed Service and the Application for 10-Point Veteran Preference, Standard Form 15.
- recently separated (within the past 3 years); OR,
- are a disabled veteran; OR,
- served on active duty during a war, campaign or expedition; OR,
- received an Armed Forces Service Medal?
For more information, review USAJOBS Veterans resources.
To verify your eligibility, you must submit a copy of your latest Certificate of Release or Discharge from Active Duty, DD-214 (copy indicating character of service) or other proof of your service which includes character of service. If claiming disability preference, you must also submit the disability letter from the Department of Veterans Affairs or Armed Service and the Application for 10-Point Veteran Preference, Standard Form 15.
18.
Are you an active duty service member expected to be discharged or released under honorable conditions within the next 120 days who will be eligible for Veterans' preference? You may eligible to apply through the Veterans Opportunity to Work (VOW) Act based on tentative preference.
To verify your eligibility, you must submit a "certification" on appropriate letterhead from your branch of service that certifies you are expected to be discharged or released from active duty service under honorable conditions not later than 120 days after the date the certification is signed. Note: If selected, prior to appointment you will be required to provide your DD-214 and/or other supporting documentation to verify that you are eligible for Veterans' preference.
For more information, review USAJOBS Veterans resources.
To verify your eligibility, you must submit a "certification" on appropriate letterhead from your branch of service that certifies you are expected to be discharged or released from active duty service under honorable conditions not later than 120 days after the date the certification is signed. Note: If selected, prior to appointment you will be required to provide your DD-214 and/or other supporting documentation to verify that you are eligible for Veterans' preference.
For more information, review USAJOBS Veterans resources.
Preferences
1.
Which of the following items describes your current or recent (within the last five years) political appointee service?
If you responded yes to any of the items below, you will need to include a SF-50 specifying your prior service.
If you responded yes to any of the items below, you will need to include a SF-50 specifying your prior service.
Your resume must be submitted in English and include the following information for each job listed:
- Job title Duties (be as detailed as possible)
- Month & year start/end dates (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Series and Grade, if applicable, for all Federal positions you have held
- Please be aware that your answers will be verified against information provided on your resume. Be sure that your resume clearly supports your responses to all of the questions by addressing your work experience in detail.
By submitting your application, you are certifying, to the best of your knowledge and belief, all the information submitted by you with your application for employment is true, complete, and made in good faith, and that you have truthfully and accurately represented your work experience, knowledge, skills, abilities and education (degrees, accomplishments, etc.). The information you provide as part of your application may be investigated. You are also certifying, and acknowledging, that misrepresenting your experience or education, or providing false or fraudulent information in, or with your application, may affect your eligibility for appointment and/or continued employment. False or fraudulent statements may be punishable by fine or imprisonment (18 U.S.C. 1001).
Assessment 1
Current Department of Veteran Affairs Employees Critical Note: Please provide your most recent performance appraisal, most recent SF-50 and your latest Within Grade Increase or Promotion SF-50 as well. The most recent SF-50 allows us to verify your current status, appointment, agency and/or duty station to confirm your Eligibility to Apply; The latest WIGI or Promotion SF-50 allows us to verify Time in Grade (TIG). Without these, we are unable to verify these requirements and you could be disqualified for not meeting Area Of Consideration, Time In Grade or not providing the proper documentation for us to do so. ALL APPLICANTS Critical Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have at least 52 weeks one (1) full year of Specialized Experience at or comparable to the required grade level. Failure to provide the required information on your resume to accurately assess your experience may result in being deemed unqualified for this position. Information on building federal resumes can be found at: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/ (https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/)
Please choose the answers below that best describe your employment and experience.
Select “Yes” or “No” to the following question(s).
1.
GS-06 Specialized Experience: Do you possess at least one (1) full year of specialized experience, which equips you with the knowledge, skills, and abilities to perform successfully the duties of the (Reimbursable Billing Technician), GS-06 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the grade GS-05 level in Federal service to qualify at the grade GS-06.
Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Identifies, reviews, analyzes, process and completes co-payments and insurance encounters and other billing related activities.4)Independently reviews and processes all specialty billing encounters.5) Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Identifies, reviews, analyzes, process and completes co-payments and insurance encounters and other billing related activities.4)Independently reviews and processes all specialty billing encounters.5) Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
2.
GS-07 Specialized Experience: Do you possess at least one (1) full year of specialized experience, which equips you with the knowledge, skills, and abilities to perform successfully the duties of the (Reimbursable Billing Technician), GS-07 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the grade GS-06 level in Federal service to qualify at the grade GS-07.
Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Initiates, gathers, and processes 3rd party revenue actions related to legal case activities by applying appropriate and relevant guidelines.4)Researches and recognizes data for dialysis billing to 3rd party insurance companies using a specified patient claims information system database.5) Conducts assigned ad hoc corrective projects, answers questions, and solves agency revenue account problems.6) Assists in synchronizing and the operationalization of all revenue activities.7) Accesses various menu options to identify, review, analyze, process and complete co-payments and insurance encounters and billing related activities.
Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
Examples of specialized experience include:1)Provides customer service to meets the needs of the customer.2)Provides patient education to a diverse customer base utilizing telephone, face to face, electronic or written correspondence.3)Initiates, gathers, and processes 3rd party revenue actions related to legal case activities by applying appropriate and relevant guidelines.4)Researches and recognizes data for dialysis billing to 3rd party insurance companies using a specified patient claims information system database.5) Conducts assigned ad hoc corrective projects, answers questions, and solves agency revenue account problems.6) Assists in synchronizing and the operationalization of all revenue activities.7) Accesses various menu options to identify, review, analyze, process and complete co-payments and insurance encounters and billing related activities.
Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and certification requirements for secondary billing.
Select the one statement that most accurately describes your training and experience carrying out each task using the scale provided.
3.
Assigns disposition instructions, and implements the most responsive and cost-effective means for managing them.
4.
Independently researches, analyzes, generates, and corrects co-payments for care as it pertains to a variety of complex programs.
5.
Accesses, retrieves, manages, and processes various revenue reports.
6.
Accesses various menu options to identify, review, analyze, process and complete co-payments and insurance encounters and billingrelated activities.
7.
Verifies the copayment status of actions and specific program requirements for care received to determine whether copayments for care outside the Agency and/or retroactive billing of copayments based on income-based exemption determinations are required.
8.
Initiates, gathers, and processes 3rd party revenue actions related to legal case activities by applying appropriate and relevant guidelines
9.
Resolves operational problems as it applies to patient accounts.
10.
Assists in synchronizing and the operationalization of all revenue activities.
11.
Applies analytical and evaluation techniques to determine if co-payment bills are appropriate.
12.
Provides independent investigation, judgment, calculation, and correction of co-payments that utilize multiple information system.
13.
Collaborates with the local VAMC eligibility and enrollment services and VA Health Eligibility Center staff to ensure Veteran customer accounts needing corrective action are addressed.
14.
Performs research to answer questions or provide other information related to Congressional investigations, inquiries from VAMC staff such as care providers and Patient Advocates, VSOs, and VA HRC inquiries
15.
Independently reviews and processes all specialty billing encounters to determine the appropriate action to be taken.
16.
Reviews, analyzes, researches, and verifies insurance policy coverage, filing time frames, COB information and pre-certification requirements for insurance billing associated with care.
17.
Independently identifies, analyzes, researches, and verifies patient visit information in multiple computer systems to identify insurance billable episodes of care.
18.
Documents current account status for all billing and accounting actions, transactions and decisions on the patients' co-payment bills and identifies when encounters are considered billable or Non-billable.
19.
Prepares dialysis billing using a process not typically inclusive of other 3rd party billing processes due to differences in data and billing requirements for such claims and dialysis care delivery outside of VAMCs, but paid for by VA.
20.
Prepares specialty-specific 3rd party billing transactions, which are more complex and require research, preparation, and problem solving beyond traditional 3rd party billing actions.
21.
Provides customer service to meet the needs of customers while supporting the mission with the specified guidelines.
22.
Provides patient education and assistance via telephone, face to face, electronic or written correspondences and must have the ability to communicate to a diverse customer base.
23.
Independently determines the best course of action for both external and internal customers co-payments, insurance and pharmacy billing and other benefit-related activities involve the use of many different methods and resources.
24.
Provides sufficient information to patients, their families, external secondary advocates, internal and external governmental agencies and/or elected officials to determine the required or most appropriate actions to take or opt in to benefits or privileges, afforded to patients under Federal law and/or Regulations.