This position is located in the Purchased/Referred Care at an IHS Service Unit. The purpose of the position is to administer the provision of Purchased/Referred Care in compliance with regulatory requirements set forth in the 42 CFR, Subpart 136, to determine patient's eligibility, defining and interpreting PRC regulations and guidelines and maintaining records. Employee identifies and assists patients who may be eligible for coverage by third party resources.
Duties
Implement screening in and interviewing methods to identify eligible for alternate resources. Communicates with patients, facility staff, and a variety of offices that provide alternate resources. Follows up on impending eligibility cases. Provides information on rights and benefits of multiple resources and advice of non-approved or approval of benefits case.
Salary
Qualifications
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. BASIC REQUIREMENT(S): 1 year equivalent to at least next lower grade level In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: GS-06-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-05 level in the Federal service as described in the vacancy announcement. Examples include: Retrieve, organize, and prepare medical records upon request; Scan documents; File reports and other pertinent information into the paper record in accordance with regulations; Perform routine clerical duties. GS-07-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-06 level in the Federal service as described in the vacancy announcement. Examples include: Apply policy and regulations related to medical records confidentiality; Analyze and code medical records in automated record systems; File and purge inactive charts; Interact with personnel for corrective coding and data entry. GS-08-1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-07 level in the Federal service as described in the vacancy announcement. Examples include: Provide information or rights and benefits of multiple alternate resources and advise patients of nonpayment or approval of claim. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
There are no education requirements.
Required Documents
Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed, annual salary, and description of job duties. Include name and address of employer; supervisor name and telephone number. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/dup/assets/public/raca/online_forms/pdf/1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference. Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov. Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf. Current or former Federal employee: Include your most recent SF-50 or if Reinstatement eligible include your Career SF-50. Noncompetitive eligibles: Submit additional documents to prove your eligibility to apply to this vacancy. You must meet the requirements of the job by 11:59 pm (Eastern Standard Time) of the closing date: 01/31/2025 Your resume and any documents submitted will be retained for three months and may be used at any time during this period. After 3 months, you must reapply to this announcement in order to be considered.
How to Apply
To apply for this position, you must provide a complete Application Package. See required documents below. Click 'Apply' to create an account or log in to your existing USAJOBS account. Follow the prompts to upload your resume and/or supporting documents. Read all Eligibility questions and respond accordingly. . Complete the assessment questions. Verify all required documentation is included in your application package. The IHS provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application and hiring process, please notify the Human Resources Office (Janell Ward, Janell.Ward@ihs.gov, and/or 202-597-1220.) The decision on granting reasonable accommodation will be on a case-by-case basis. For additional questions please see our Frequently Asked Questions (FAQs) found here: http://www.ihs.gov/jobs/index.cfm?module=search&option=faq.
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