Contact Representative (Benefits Coordinator)

Join the Indian Health Service as a Contact Representative and support access to healthcare services for American Indian communities. Assist patients with eligibility, medical authorizations, referrals, and healthcare benefits while building a rewarding career in public service and healthcare administration. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Duties

• Assists patients in identifying and obtaining alternate health care resources, including Medicare, Medicaid, VA, Tribal, and other third-party programs.
• Conducts patient interviews to gather information for eligibility determinations and enrollment.
• Assists with completing applications, verifying eligibility, and maintaining enrollment records.
• Provides information regarding benefits, coverage, program requirements, and available resources.
• Coordinates with patients, families, healthcare staff, and external agencies to obtain required information and facilitate referrals.
• Follows up on pending applications, enrollments, and claims to support timely processing.
• Assists in resolving eligibility, coverage, and reimbursement issues in accordance with established policies and procedures.
• Maintains confidential patient information and records in compliance with Privacy Act and HIPAA requirements.
• Utilizes automated systems to document, track, and report eligibility and enrollment activities.
• Supports patient access to healthcare services through effective customer service and application of alternate resource program requirements.

Salary

• $45,409 - $72,644/year

Conditions of Employment

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

This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.

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/.

Selectee(s) must maintain an active bank account with a financial institution to receive salary payments through electronic direct deposit.

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.

Financial Suitability Requirement:

This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.

Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).

Prior to the appointment, candidates must present two valid forms of identification. If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant.

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.

MINIMUM QUALIFICATIONS:

GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.

GS-07: 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: assisting patients with alternate resources and eligibility processes; conducting patient interviews to obtain information for program eligibility and enrollment; providing information on Medicare, Medicaid, Tribal, and other healthcare programs; reviewing applications and supporting documentation for completeness; coordinating with patients and outside agencies to obtain required information; maintaining confidential patient records; and applying established policies, procedures, and guidelines in a healthcare setting.

GS-08: 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: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues.

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. Other Information Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. (https://appsupport-usastaffing.opm.gov/hc/en-us/sections/45063131363475-Reasonable-Accommodation-Information) Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. This position may or may not be covered by a bargaining unit, depending on the duty location. Final determination will be made at the time of appointment. Recruitment or relocation incentives may be authorized. At least a 6 month service agreement will be required. This position has promotion potential to the GS-GS-8 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied. You will be evaluated for this position in accordance with the OPM Merit Hiring Plan. As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions. How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government? In this role, how would you use your skills and experience to improve government efficiency and effectiveness? How would you help advance the President's Executive Orders and policy priorities in this role? How has a strong work ethic contributed to your professional, academic or personal achievements? Your responses are optional and will not be scored. However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process. You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot). Required Documents

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: Verification of Indian Preference for Employment in the BIA and IHS 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.

This is an Open Continuous Announcement. Applications will be reviewed and referred as vacancies occur; however, there may not be immediate openings at all locations.

During the application process, you may select up to five locations and will only be considered for positions in those locations. Candidates with complete applications will remain eligible for consideration for up to three months from the date of application or until the announcement closes, whichever occurs first. Consideration will be based on your selected locations, qualifications, and job preferences.

Positions may be filled at any of the grade levels listed in this announcement, with or without promotion potential. Applicants should indicate the lowest GS grade level they are willing to accept.

The first application cut-off date for referral consideration will be five business days after the announcement opens. After that, applications may be reviewed and referred at any time as vacancies occur.

How to Apply

Please read the entire announcement and all the instructions before you begin an application. To apply and be considered for this position, you must complete all required questionnaires, assessments and submit all required documentation as specified in the How to Apply and Required Documents section. The complete application package must be submitted by 11:59 PM (ET) on the closing date of the announcement to receive consideration. The application process is as follows:

1. Click the Apply Online button.
2. Answer the questions presented in the application and attach all necessary supporting documentation.
3. Click the Submit Application button prior to 11:59 PM (ET) on the announcement closing date.
4. If you are required to complete any USA Hire Assessments, you will be notified after submitting your application. The notification will be provided in your application submission screen and via email. The notification will include your unique assessment access link to the USA Hire system and the completion deadline. Additionally, in USAJOBS you can click "Track this application" to return to your assessment completion notice.
5. Access USA Hire using your unique assessment link. Access is granted through your USAJOBS login credentials.
6. Review all instructions prior to beginning your assessments. You will have the opportunity to request a testing accommodation before beginning the assessments should you have a disability covered under the Rehabilitation Act of 1973 as amended.
7. Set aside about two (2) hours to take the USA Hire Assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue later, you can re-use your unique assessment link.
8. Your responses to the USA Hire Assessments will be reused for one year (in most cases) from the date you complete an assessment. If future applications you submit require completion of the same assessments, your responses will be automatically reused.

Visit the USA Hire Applicant Resource Center for practice assessments and assessment preparation resources at https://support-usahire.opm.gov/hc/en-us.

To update your application, including supporting documentation: During the announcement open period, return to your USAJOBS account, find your application record, and click Edit my application. This option will no longer be available once the announcement has closed.

To view the announcement status or your application status: Visit https://www.usajobs.gov/Help/howto/application/status/. Your application status page is where you can view your application status, USA Hire assessment completion status, and review your notifications sent by the hiring agency regarding your application.

You may update your application documents and some questions related to your personal information at any time during the announcement open period. Upon application, you may be provided a testing window to complete additional assessments. This testing window may stipulate a completion deadline before the announcement closes. It is your responsibility to complete the additional online assessments within the timeline provided to remain in consideration for this vacancy announcement. Failure to complete the online assessments within the testing window for this announcement will not preclude you from being considered for and completing the online assessments during a testing window on a future announcement.

For additional questions please see our Frequently Asked Questions (FAQs) found here: https://www.ihs.gov/jobs/faq/.