Medical Reimbursement Technician

***THIS IS NOT A VIRTUAL POSITION YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION***

This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance availability of higher-level work and availability of funds.

Duties include but may not be limited to the following:

• Performs verification of patient insurance coverage.
• Obtains patient insurance information through automated databases direct patient contact and contact with insurance companies.
• Verifies benefits policy number pre-certification requirements and effective dates of coverage.
• Updates and maintains patient information in an electronic database.
• Generates monthly reports as required.
• Ensures that all billable cases are identified and that bills are accurately generated.
• Validates claims for billing purposes ensuring eligibility and referring questionable coding for review.
• Tracks reviews and corrects denials.
• Obtains required information and coordinates completion of forms with patients staff and providers.
• Responds to patients questions explaining eligibility requirements insurance provisions and billing and payment procedures.
• Performs third party collection from insurance companies and accounts receivable functions.
• Verifies the accuracy of payments resolves problems and discrepancies and closes out accounts.
• Performs other related duties as required.

• You must be a U.S. Citizen to apply for this job
• To be considered for this position you must complete all required steps in the process. In addition to the application and questionnaire this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.
• Selective Service Registration is required for males born after 12/31/1959
• Physical Requirements: The work may require some physical effort such as periods of standing walking or bending. There are no special physical demands.
• Subject to background/security investigation
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements ( Effective May 7 2025 drivers licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) - See Required Documents below for details.

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

SPECIALIZED EXPERIENCE GS-05: Applicants must possess at least one (1) full year of specialized experience that equipped them with the particular knowledge skills and abilities to perform successfully the duties of this position and that is typically in or related to the work of this position. To be creditable this experience must have been equivalent to at least the GS-4 level in the Federal service. Examples of specialized experience include: following instructions about timeliness objectives and relative priorities for doing administrative work; communicating with co-workers and supervisors to discuss administrative concerns; and reviewing and determining the appropriateness of administrative data.. NOTE: Experience must be documented within the resume to receive credit indicating clearly the nature of duties and responsibilities in each position month and year and the number of hours a week spent in such employment.
OR
SUBSTITUTION OF EDUCATION FOR EXPERIENCE GS-05: You must have successfully completed a bachelors degree or 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite This education must have been obtained in an accredited business secretarial or technical school junior college college or university. One year of full-time academic study is defined as 30 semester hours 45 quarter hours or the equivalent in a college or university or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business secretarial or technical school. NOTE: Transcript required with application.
OR
COMBINATION OF EDUCATION AND EXPERIENCE GS-05: An equivalent combination of specialized experience and post high school education as described above that demonstrates the ability to perform the duties of this position. NOTE: Transcript required with application.


SPECIALIZED EXPERIENCE GS-6: Applicants must possess at least one (1) full year of specialized experience that equipped them with the particular knowledge skills and abilities to perform successfully the duties of this position and that is typically in or related to the work of this position. To be creditable this experience must have been equivalent to at least the GS-5 level in the Federal service. Examples of specialized experience include: following instructions about timeliness objectives and relative priorities for doing administrative work; communicating with co-workers and supervisors to discuss administrative concerns; reviewing and determining the appropriateness of administrative data; validating claims for billing purposes by ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing. Experience must be documented within the resume to receive credit indicating clearly the nature of duties and responsibilities in each position month and year and the number of hours a week spent in such employment.

For more information on these qualification standards please visit the United States Office of Personnel Managements website at 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies knowledge and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience including volunteer experience.

Required Experience:

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