Job Description

To qualify for this position at the FV-G (GS/FG 10/11) level, you must demonstrate in your application that you possess at least one (1) year of specialized experience equivalent to FV-F (GS/FG 7-9) level. Specialized experience is experience that has equipped you with the particular knowledge, skills, and abilities to perform successfully the duties of the position to be filled. SPECIALIZED EXPERIENCE includes: Medical experience reviewing documents in case files/medical records for completeness and accuracy; using a variety of legal or regulatory references for document verification; analyzing data obtained from documents such as claim forms, application forms, contracts, medical records, or other legal/medical documents in order to make determinations; and researching and responding to inquiries/questions. AND SELECTIVE PLACEMENT FACTOR (SPF): Candidates must demonstrate evidence of having skill in examining documents that denote the diagnosis and treatment of disease, injuries, and deformities and includes prescription and other over-the-counter medicines and pharmaceuticals within their resume. Candidates who do not possess the SPF are rated ineligible/not qualified and will not receive further consideration for the position. Applicants should provide examples of Specialized Experience in their Work History. Qualifications must be met by the closing date of the vacancy announcement.