Health System Specialist (Document Improvement Specialist)
Indian Health Service
Summary This position is located at the Phoenix Indian Medical Center in Phoenix, Arizona. The purpose of this position is to train, evaluate, analyze, and provide oversight down the lines of Patient Access Manager and Revenue Manager for a complex healthcare facility. As such, the incumbent provides advice to the Supervisor, Patient Access Manager, and Revenue Manager as required. Successful performance is critical to the enhancement of our revenue cycle management improvement efforts. Responsibilities Train staff to improve processes and ensure that all patient information is accurate and detailed. Planning Activities - Performs long and short-range planning, provides evaluation to supervisor, and analysis; and projects of future resource requirements. Personnel Administration - Develops and implements policies and procedures and training methodologies, creates training manual; and monitors section data activity, which entails daily, weekly, and monthly error corrections that involve researching and analyzing computer-generated reports, including determining whether files should be deleted/merged, edited, or updated. Continuous Quality Improvement - Develops and implements a comprehensive internal quality control system that measures the effectiveness of such controls and their impact on the program. Maintains working knowledge of Medicare/Medicaid and Private Insurance benefits to ensure that the facility is in compliance with Indian Health Service and DHHS regulations. Performs a variety of Benefit Coordinators, Patient Registration (Outpatient/Inpatient), and Revenue, confirming the eligibility of patients in accordance with IHS and Phoenix Area guidelines. Assists in the development and implementation of PBS policies and procedures regarding patient accounts, use of Resource Patient Management Systems (RPMS), Electronic Health Record and the Registration (BPRM), alternate resources programs, and training methodologies. Requirements Conditions of Employment Must pass pre-employment examination. Selectee may be subject to a probationary/trial 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. Confidential Financial Disclosure Form required. Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities. 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: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process. 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. Individual Occupational Requirements: Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR SPECIALIZED EXPERIENCE: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organization echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR Special Provision for In-Service Placement: Successfully completed an agency-sponsored on-the-job training program that may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. In addition to the Individual Occupational Requirement, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS:GS-9: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-7 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 delivery systems; regulatory agencies, e.g, Centers for Medicaid and Medicare Services (CMS) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Knowledge and understanding of IHS statutes and policies related to third party billing, accounts receivable and appeals and denials. Knowledge of purchased and referred health care services within IHS and public/private sectors. Knowledge and writing skills in the development of position papers, proposals, recommended program changes, systems modifications and other products to streamline the Patient Business Office. OR Education: Master's or equivalent degree or completed 2 full years of progressively higher level graduate education leading to such a degree, or LL.B. or J.D. Degree or education must have included major study in hospital administration, public administration, or related fields such as business or public administration with course work in health care administration. Must provide copies of transcripts; OR Combination of education and specialized experience: Combination of experience and graduate education that when combined, meets 100% of the qualification requirements for this position. Only graduate education in excess of 36 semester hours may be used in the calculation. To calculate your percentage of experience, divide y our total number of months by 12 months. To calculate your percentage of education, divide your graduate hours earned by 18 semester hours. Finally, add the two percentages. The total percentage must equal at least 100% to qualify. Must provide copies of transcript GS-11: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-9 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Comprehensive knowledge of health care delivery systems; regulatory agencies, e.g. Centers for Medicaid and Medicare Services (CMS), Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Knowledge and interpretation of federal law and regulations, policies, and procedures, in order to provide guidance, advice, interpretation and explanation of federal regulations and third-party program interactions. Utilizes the Patient Registration package of RPMS to monitor performance and conducts audits on third party resource data, recording the information and submitting reports. OR Education: Ph.D. or equivalent doctoral degree or completed 3 full years of progressively higher level graduate education leading to such a degree, or LL.M. Degree or education must have included major study in hospital administration, public administration, or related fields such as business or public administration with course work in health care administration. Must provide copies of transcripts; OR Combination of education and specialized experience: Combination of experience and graduate education that when combined, meets 100% of the qualification requirements for this position. To determine if you qualify under this combination first divide your total months of qualifying experience by 12. Then divide your semester hours of graduate education beyond 3 years by 18. (Note: Only education in excess of the third year is creditable toward meeting the experience requirement when combining experience and education. Finally, add the two percentages. The total percentage must equal at least 100% to qualify. Must provide copies of transcript. 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 This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer. Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. 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 is covered by a Bargaining Unit. Recruitment and/or Relocation Incentives may be authorized and is subject to availability and service unit approval. If offered, you will be required to sign a one (1) year service agreement. Failure to fulfill the service agreement will result in repayment of the incentive. This position has promotion potential to the GS-11 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.
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