Financial Accounts Technician
Duties can include, but are not limited to:
Captures insurance information on all non-service connected, service-connected and non-veteran patients who hold third party health plans by:
review of outstanding and/or denied receivables generated from follow up reports in VISTA. Audits all Tricare, ChampVA, OWCP/DOL, Allied Veteran, Ineligible Veteran and Fugitive Felons bills for accuracy and ensures authorizations are included. Interprets VA billing practices to veterans and others as appropriate. Adheres to release of information requirements, ensuring proper consent form is obtained for veterans with diagnosis of alcohol or drug abuse, sickle cell anemia or HIV. Reviews the ate type to ensure the maximum allowable billing rates are used. Maintains working knowledge of International Classification of Disease 9th Edition (ICD-9) codes, Current Procedural Terminology 4th Edition codes (CPT-4) and HealthCare Procedural Coding System (HCPCS) odes, in order to question potential errors on bills. Reviews, and analyzes all case information, determines course of action to follow to recover debts. Resolves problems encountered with debt collections; gathers pertinent information and may seek guidance from Regional Counsel before making decision. Makes inquiries as to the status of Tricare and ChampVA claims either by telephone, written or electronic correspondence. Identifies problems in claims processing and works with Tricare and ChampVA to recover payment, review notices for collection of over-payment by Tricare and ChampVA to determine validity of payment, initiating refund or having claim reprocessed for correction. Reviews health insurance coverage with patients, explains issues such as deductibles, co-payment, length of stay, and other matters that explain the VA's role in insurance reimbursement. Determines if collection action is to be pursued, if compromise should be solicited, if suspension should be recommended, or if referral should be made to enforce collection. Reconciles bill numbers to assures proper accounting records are established. Assures that bills are in proper category for reporting purposes. Prepares documentation for cases referred to Committee on Waivers, Hardships and Compromises, Regional Counsel, or Department of Justice. Work Schedule:
Monday - Friday; 8:
00am-4:
30pm Recruitment & Relocation Incentives:
Not authorized Financial Disclosure Report:
Not Required This position includes a Selective Placement Factor (skill, knowledge, ability or other worker characteristic basic to - and essential for - satisfactory performance of the job). Selective Placement Factors are a prerequisite to appointment and represent minimum requirements for a position. Applicants who do not meet it are ineligible for further consideration. The Selective Placement Factor for this position is:
Having working experience in Medical Claims which includes working knowledge of reviewing Health Insurance coverage with patients, explaining issues such as deductibles, co-payments and other matters; International Classification of Disease 9th edition (ICD-9) codes, Current Procedural Terminology 4th edition codes (CPT-4) and Healthcare Procedural Coding System (HCPCS) codes. Note:
Experience must be documented in your resume. SPECIALIZED
Experience:
GS-6:
One (1) year of specialized experience that equips you with the knowledge, skills and abilities to successfully perform the duties of the position. To be creditable for the GS-06 the experience must have been equivalent to the GS-05 in Federal service. Examples of experience includes:
knowledge of eligibility, claim submission procedures, release of Information functions, including the Privacy Act, medical terminology, medical record format and eligibility requirements; ability to interpret the individual regulation, reconcile billing services, having a working knowledge of ICD-9, CPT-4, and HCPSC to denied claims for denial reversals; understanding of record keeping, insurance company-specific regulation, and Means Test regulations; and having working knowledge of standard office software applications essential to billing services. You will be rated on the following Competencies as part of the assessment questionnaire for this position:
CommunicationsComputer SkillsCustomer ServiceInsuranceMedical Information IMPORTANT:
A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. 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. 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). 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. 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/.
Estimated Salary: $20 to $28 per hour based on qualifications.
Captures insurance information on all non-service connected, service-connected and non-veteran patients who hold third party health plans by:
review of outstanding and/or denied receivables generated from follow up reports in VISTA. Audits all Tricare, ChampVA, OWCP/DOL, Allied Veteran, Ineligible Veteran and Fugitive Felons bills for accuracy and ensures authorizations are included. Interprets VA billing practices to veterans and others as appropriate. Adheres to release of information requirements, ensuring proper consent form is obtained for veterans with diagnosis of alcohol or drug abuse, sickle cell anemia or HIV. Reviews the ate type to ensure the maximum allowable billing rates are used. Maintains working knowledge of International Classification of Disease 9th Edition (ICD-9) codes, Current Procedural Terminology 4th Edition codes (CPT-4) and HealthCare Procedural Coding System (HCPCS) odes, in order to question potential errors on bills. Reviews, and analyzes all case information, determines course of action to follow to recover debts. Resolves problems encountered with debt collections; gathers pertinent information and may seek guidance from Regional Counsel before making decision. Makes inquiries as to the status of Tricare and ChampVA claims either by telephone, written or electronic correspondence. Identifies problems in claims processing and works with Tricare and ChampVA to recover payment, review notices for collection of over-payment by Tricare and ChampVA to determine validity of payment, initiating refund or having claim reprocessed for correction. Reviews health insurance coverage with patients, explains issues such as deductibles, co-payment, length of stay, and other matters that explain the VA's role in insurance reimbursement. Determines if collection action is to be pursued, if compromise should be solicited, if suspension should be recommended, or if referral should be made to enforce collection. Reconciles bill numbers to assures proper accounting records are established. Assures that bills are in proper category for reporting purposes. Prepares documentation for cases referred to Committee on Waivers, Hardships and Compromises, Regional Counsel, or Department of Justice. Work Schedule:
Monday - Friday; 8:
00am-4:
30pm Recruitment & Relocation Incentives:
Not authorized Financial Disclosure Report:
Not Required This position includes a Selective Placement Factor (skill, knowledge, ability or other worker characteristic basic to - and essential for - satisfactory performance of the job). Selective Placement Factors are a prerequisite to appointment and represent minimum requirements for a position. Applicants who do not meet it are ineligible for further consideration. The Selective Placement Factor for this position is:
Having working experience in Medical Claims which includes working knowledge of reviewing Health Insurance coverage with patients, explaining issues such as deductibles, co-payments and other matters; International Classification of Disease 9th edition (ICD-9) codes, Current Procedural Terminology 4th edition codes (CPT-4) and Healthcare Procedural Coding System (HCPCS) codes. Note:
Experience must be documented in your resume. SPECIALIZED
Experience:
GS-6:
One (1) year of specialized experience that equips you with the knowledge, skills and abilities to successfully perform the duties of the position. To be creditable for the GS-06 the experience must have been equivalent to the GS-05 in Federal service. Examples of experience includes:
knowledge of eligibility, claim submission procedures, release of Information functions, including the Privacy Act, medical terminology, medical record format and eligibility requirements; ability to interpret the individual regulation, reconcile billing services, having a working knowledge of ICD-9, CPT-4, and HCPSC to denied claims for denial reversals; understanding of record keeping, insurance company-specific regulation, and Means Test regulations; and having working knowledge of standard office software applications essential to billing services. You will be rated on the following Competencies as part of the assessment questionnaire for this position:
CommunicationsComputer SkillsCustomer ServiceInsuranceMedical Information IMPORTANT:
A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. 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. 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). 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. 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/.
- Department:
0503 Financial Clerical And Assistance - Salary Range:
$47,477 to $61,722 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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