Summary This position is located in the Third Party Billing and Accounts Receivable Section of the Patient Business Office in the Division of Financial Services at the Phoenix Indian Medical Center. The incumbent abstracts and interprets data from records in preparation for submission and resubmission of third party claims. Responsibilities Assists in mailing of claims and all Third Party Reimbursable data. Identifies denied claims and assess the Reason Codes associated with payment and reimbursement from Third Party Sources. Files all pending and completed claims and correspondence relative to the third party and primary care provider programs. Maintains Medicare, Medicaid and private/commercial insurance manuals and directives; Provider Reimbursement Manual; Direct Dealings provider letters, Federal Health Insurance for the Aged; and transmittals of bills. Files all pending and completed health insurance claims and correspondence relative to the third party resources. Receives visitors and telephone calls and refers them to proper personnel or furnishes information requested; routes, controls and distributes mail to individuals in accordance with established procedures and knowledge of the organizations personnel. 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. Adherence to the IHS Employee Immunization Policy, SGM 21-04, and the IHS Circular 2016-04 requiring Measles and Rubella, COVID-19, and seasonal influenza immunizations for staff working in Indian Health Service health care facilities OR an exemption request will need to be submitted. 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. MINIMUM QUALIFICATIONS for the GS-4 Grade Level: At least (1) year of general experience. General experience is progressively responsible clerical, office or other work that indicates ability to perform the work of this position at the GS-4 level. -OR- At least (2) years of education above the high school level. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. -OR- A combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage must equal at least 100 percent to qualify for the GS-4 level. MINIMUM QUALIFICATIONS for the GS-5 Grade Level: At least (1) year of specialized experience equivalent to at least the GS-04 grade level that equipped me with the knowledge, skills and abilities to successfully perform the duties of this position. Examples include: Abstracting and interpreting data from records in preparation for submission and resubmission of third party claims. -OR- At least (4) years of education above the high school level. -OR- A combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage must equal at least 100% to qualify an applicant for the GS-5 level. Typing Proficiency Requirement: You must be able to type at least 40 words per minute 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. This position has promotion potential to the GS-05 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.