Summary The purpose of this position is to verify patient eligibility for all third party resources at the Crownpoint Service Unit. The incumbent will report to the Supervisory Health System Specialist, Division of Administrative Services in Crownpoint, NM. This position is being re-advertised to solicit additional applications. Applicants who applied previously need not reapply unless submitting updated and\/or missing information. Responsibilities Verification of all third party resources and workers compensation for all registrations. Utilizes electronic eligibility system for those third party resources with electronic verification capability. Performs telephone verification for third party resources that do not provide electronic eligibility query. Maintains, Key-enters, updates and verifies all alternate resources data necessary for patient registration and admission and for accurate billing through the use of the RPMS Patient Registration System and electronic eligibility system. Places telephone calls to insurance companies for the insured to enroll dependents, such as newborns. Verifies that patient information related to third party beneficiaries and Medicare, Medicaid such as, insurance claim number, type of coverage, spelling of names, birth dates, and other demographic information are correct and corresponds to CHCF third party payment system and RPMS requirements. Works closely with the Patient Registration and facility staff in screening for potential eligible by assuring identification and utilization of all alternate resources available to the Indian population. Identifies, follow-up and processes information on those patients, whose health benefits are subject to prior approval or require pre-certification to determine the extent of health care for both inpatient and outpatient. Performs other related duties as assigned. Requirements Conditions of Employment 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. COVID-19 vaccination is required for all selectees prior to entrance on duty.. 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. BASIC REQUIREMENT(S): GS-05: One (1) year of specialized experience equivalent to at least the GS-04 grade level; OR, Four (4) years above high school. 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: Experience in verification of all third party resources and workers compensation for all registrations. Utilizing electronic eligibility system for those third party resources with electronic verification capability. Maintaining, Key-entering, updating and verifying all alternate resources data necessary for patient registration and admission and for accurate billing through the use of the RPMS Patient Registration System and electronic eligibility system. Identifying types of coverage policyholders are entitled to, informs billing office on changes on insurance carriers with employers. Following up all pending verifications and works closely with families and agencies to see that the Indian patients are not discriminated against because of their dual role as a citizen and as an IHS recipient. 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 http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. Additional Information Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed. Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. This position is covered by a Bargaining Unit. Government housing is not available. This position has NO promotion potential.