Billing Technician

• Receives and examines alternate resource claims to assure claims are complete with appropriate supporting documents which typically include utilization review certifications. Verifies accuracy of health claims number that claimed amounts are authorized and items of services billed are allowed by appropriate regulations decisions directives and other controlling guides.
• Provides technical assistance with processing and maintaining coding abstraction of the complete chart (outpatient) and compliance enforcement of all regulatory requirements. Review analyze Current Procedural Terminology (CPT) coding abstract and compile date maintain and identify potential risk areas in outpatient medical record.
• Conducts a thorough review of all abstraction and search of records guidelines in order to select the most accurate and descriptive codes in accordance with coding systems. Code selection involves discriminating between several different codes which can overlap in scope encompass multiple diagnosis treatments or operations; and include special codes to denote causes of accident/injury or adverse effects required for billing.
• Consults with the attending physician laboratory and all other necessary departments for compliance with all the regulations and guidelines pertinent to False Claims Act and facilities Compliance Program in preparation for itemize billing.

Selectee may be subject to a probationary 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

Successfully pass the E-Verify employment verification check. To learn more about E-Verify including your rights and responsibilities visit will need to set up direct deposit so we can pay you.

Background Investigation Requirement:

This position requires the successful completion of a federal background investigation as a condition of employment.

A background investigation is a standard process used by the Federal Government to verify an individuals identity employment history education and other relevant information to determine suitability for Federal service.

Upon receipt of instructions applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.

Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.

Financial Suitability Requirement:

This position requires a review of the applicants financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility maintain good standing with creditors and satisfy all legal financial obligations prior to applying.

Individuals with substantial delinquent or unresolved financial obligations-including but not limited to delinquent federal or state tax liabilities defaulted federal student loans court-ordered fines or fees or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).

Prior to the appointment candidates must present two valid forms of identification. If one of the documents is a state-issued ID or drivers license it must be REAL ID-compliant.

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:
GS-06: 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. Examples include: completing insurance audits prior authorizations work in a medical business office setting with responsibility for performing submission to third party payers intermediaries and patients documenting all activity performed submission of daily productivity reports to the supervisor.

GS-07: 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. Examples include: completing insurance audits prior authorizations submitting claims to third party payers and responsible parties rebilling or correcting billing of accounts previously submitted. This experience also includes such things as verifying information reviewing reports to identify claims and using the various types of computer systems.

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.