Contact Representative (Benefits)
Indian Health Service See More Job Openings by This Employer- Multiple Schedules
- $50,460 - $65,599/year
- Camp Verde, AZ View More
Join the Indian Health Service as a Contact Representative (Benefits) and make an impact. The role involves identifying patients eligible for alternate resources, assisting with enrollment, advocating on their behalf, and acting as a liaison between the IHS work unit and non-IHS providers and facilities. USAJOBS Help Center - Update your resume now so it meets new resume requirements
DutiesThere MAY NOT be immediate vacancies at all locations.
- Verifies and determines patient's eligibility for Medicare, Medicaid, Private Insurance, VA or other potential alternate resources.
- Provides information on rights and benefits of multiple alternate resources and advises patient of nonpayment or denial of claims.
- Identifies and follows up on pending applications and timely entry of all third party resources.
- Conducts face-to-face interviews or by telephone with patients and/or families to ensure accurate and complete enrollment application.
- Obtains copies of verification of household income or other source of documentation, requests all other income from beneficiary and household members.
- Initiates medical authorizations and denial of service for inpatient/outpatient/ancillary medical services for eligible IHS beneficiaries. Investigates and analyzes controversial issues.
- Issues correspondence to patients, health care providers and other agencies regarding eligibility, IHS policy and regulations, including letters of denial of payment where the requirements of the IHS Program are not met.
- Tracks all referrals to non-IHS facilities to include those referrals to other IHS facilities to support the Case Management activities and continuity of care efforts. Participates in the weekly Case Management meetings, takes minutes and prepares the minutes for record and reporting purpose.
- $50,460 - $65,599/year
Selectee may be subject to a probationary period
ESEP appointees typically serve a two year trial period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959
IHS Selectees that will work in an IHS health care facility may be subject to Employee Health Policies related to Measles and Rubella, and seasonal influenza immunizations. Vaccine exemption requests may be available according to the National and/or Service Unit guidance.
On-call hours or standby duty may be required.
Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
You will need to set up direct deposit so we can pay you.
Background Investigation Requirement:
This position requires the successful completion of a federal background investigation as a condition of employment.
A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.
Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.
Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.
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.
MINIMUM QUALIFICATIONS:
GS-07: One (1) year of specialized experience equivalent to the GS-06 grade level.
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: Knowledge of, and ability to apply a multitude of Alternate Resource regulations, knowledge of medical terminology, ability to act as an advocate for patients, ability to maintain effective work relationships with patients, co-workers, and community, knowledge of Privacy Act and HIPAA, use of confidential information and health records, and maintaining confidential patient information.
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 by the respective cut-off day of rating to be eligible for consideration.
USAJOBS Help Center - Update your resume now so it meets new resume requirements.
Resume: You are highly encouraged to visit the USAJOBS Help Center before submitting a resume. USAJOBS Help Center - Update your resume now so it meets new resume requirements
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/media_document/1076-0160_indian-pref_expires-04.30.25_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.
- Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application. You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer.
- Licensure, Certifications: Applicants should list their license/certifications on their resume, along with the expiration date, if applicable. Certification of licensure/certification will be required after tentative selection and prior to issuing an official job offer.
You must complete the application process and submit all required documents electronically by 11:59 p.m. (Eastern Standard Time) of the cut-off date/day listed.
Your application will remain active for 90 days from the submission of application.
How to ApplyTo apply for this position, you must provide a complete Application Package. See required documents below.
- To begin, click the Apply Online button on the vacancy announcement.
- You will be directed to the Login.Gov screen, here will you sign in if you have an existing USAJOBS account or Create a Login.Gov account.
- If you have an account you will be directed to select a resume or create a resume. If you create an account you can create an resume. Click save and continue.
- Follow the prompts to upload your resume and/or supporting documents.
- Click the Apply To This Vacancy and complete all steps in the application process until the Confirmation indicates your application is complete. If you click Return to USAJOBS or get timed out prior to receiving confirmation, your application will not be submitted and cannot be considered for this job.
- Read and complete all Eligibility questions.
- Review the REQUIRED DOCUMENTS section of this announcement to determine which apply to you and must be submitted online. You may choose one or more of the following options to submit your document(s): Upload (from your computer) or USAJOBS (click the "USAJOBS" link to complete the transfer process).
Helpful Hints for Creating a Two-Page Resume:
- Prioritize most relevant and recent experience
- Use concise, results focused language
- Align language from the job announcement
- Focus on demonstrating skills and competencies
- Remove outdated or unrelated experience
- Use the USAJOBS resume builder
For additional questions please see our Frequently Asked Questions (FAQs) found here: http://www.ihs.gov/jobs/index.cfm?module=search&option=faq.
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. The decision on granting reasonable accommodation will be on a case-by-case basis.