Medical Reimbursement Technician

NORTH CENTRAL CPAC • Middleton, WI • 12h ago

JOB REQUIREMENTS: Verify accuracy of billing data and revise any errors. Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software. 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. Performing other related duties assigned. ** OTHER EXPERIENCE AND QUALIFICATIONS: SPECIALIZED EXPERIENCE: Have at least one (1) full year of specialized experience that equipped you 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 this Medical Reimbursement Technician position. To be creditable, specialized experience must have been equivalent to at least the next lower level of Federal service. Examples of qualifying specialized experience include: Verification of patients/customer information, entering data into the patients/customer account and automated databases, communication with internal and external customers, meeting required timelines, and administrative support. NOTE: 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. SUBSTITUTION OF EDUCATION FOR EXPERIENCE: Have successfully completed four (4) years of education above high school in any field for 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. NOTE: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation. COMBINATION OF EXPERIENCE AND EDUCATION: Have an equivalent combination of specialized experience and post high school education as described above that demonstrates your ability to perform the duties of this position.NOTE: 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. Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation. TO QUALIFY FOR THIS POSITION AT THE GS-6 GRADE LEVEL, YOU MUST MEET THE FOLLOWING CRITERIA: SPECIALIZED EXPERIENCE: Have at least one (1) full year of specialized experience that equipped you 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 this Medical Reimbursement Technician position. To be creditable, specialized experience must have been equivalent to at least the next lower level of Federal service. In addition to the examples provided at the GS-05 level, examples of qualifying specialized experience include: Validating claims for billing purposes; Ensuring eligibility and referring questionable coding for review; and Interpreting insurance policies and requirements for billing. NOTE: Experience must be fully documented on your resume and must include job title,month and year start/end dates AND hours worked per week. A full year of work is considered to be 40 hours/wk ** APPLICATION INSTRUCTIONS: Apply Online: https://www.usajobs.gov/job/870467300

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