Job Description
Who May Apply: US Citizens In order to qualify, you must meet the education/ experience requirements described below. 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; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. This position is being filled at the GS-07 level with promotion potential to GS-09. The duties described reflect the full-performance GS-09 level. Duties performed at the developmental GS-07 level will be completed under appropriate guidance and oversight from a lead or supervisor. Management may select at either grade level, with the full-performance level being GS-09. Specialized Experience: GS 07 - One year of specialized experience which includes reviewing medical billings, verifying the accuracy of patient claims, entering data within a fully automated billing or collections system. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). OR Education: One full year of graduate level education in a field which demonstrates the knowledge, skills, and abilities necessary to do the work of the position, such as Budget Administration, Accounting, Finance or similar field of study. OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) by 18. Add the two percentages. Specialized Experience: [GS 09] One year of specialized experience which includes processing patients claims to third party payers; reviewing insurance bills or medical claims; utilizing financial management and/or budget automated systems. This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07). OR Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, in a field which demonstrates the knowledge, skills, and abilities necessary to do the work of the position, such as: Budget Administration, Accounting, Finance or similar field of study. OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two
8:00 AM
Pull your AR worklist. Claims are sorted by payer, days in AR, and dollar amount. Priority: anything over 60 days old and over $1,…
8:30 AM
Work a batch of Medicare claims stuck in 'processing' status. Log in to the Medicare FISS portal, check claim status on each one.…
9:30 AM
Call the Cigna provider line for a claim that's been in process for 45 days. On hold for 18 minutes. The rep tells you the claim w…
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