Billing Technician

SummaryThis position is located in the Business Office at the Yakama Service Unit in Toppenish, Washington. The incumbent serves as a Billing Technician responsible for processing pharmaceutical claims on-line to third party carriers which include Medicare Part D, Medicaid and Private Insurance.ResponsibilitiesVerifies prescription amount dispensed for reimbursement. Requests and obtains prior authorization for various pharmaceutical products from insurance companies. Prepares end of month and quarterly status reports which includes amounts billed, collected and outstanding. Researches and follows-up on rejected claims on-line. Maintains records and files in accordance with applicable regulations and guidance. Provides documentation to the insurance companies when requested for an audit.RequirementsConditions of EmploymentMust pass pre-employment examination.Selectee may be subject to a probationary/trial periodESEP appointees typically serve a two year trial periodU.S. Citizenship is requiredSelective 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. Measles and Rubella immunization required for selectees born after 1957. Seasonal Influenza immunization is required for civilian health care facility staff working in Indian Health Service health care facilities. 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 be required to have all federal salary payments electronically deposited into a bank account with a financial institution of your choice. 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. Fingerprinting, as part of the background investigation process, may be delayed due to COVID-19. All other background investigation procedures will apply. Be advised that your continued employment will require you to complete a fingerprint check within 60 days after notification of return to full operations and successfully obtaining a favorable background investigation.QualificationsTo 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-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent comparable in difficulty and responsibility to the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Compile account statements, compute balances and record billing payments for any company. Responsible for preparing invoices for services rendered or for the delivery of goods. Calculate interest, penalties and late fees for clients who are past due on their accounts. Work daily with both paper forms and specialized computer programs when inputting and analyzing account information; OR, 4 years of education above the high school level; OR, Possess a combination of education and experience that when combined fully meet the minimum qualifications for the GS-05 grade level. (Only education in excess of the first 60 semester hours is creditable toward meeting the specialized experience requirement). The total percentage must equal at least 100 percent to qualify an applicant for GS-05 grade level. GS-06: Your resume must demonstrate at least one (1) year of specialized experience specialized experience comparable in difficulty and responsibility to the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Analyzing billing operations for third party (health care) programs; acting as an advocate in the collection of alternate resources (insurance, Medicaid etc.); assuring collections, billed data and computerized and manual reports are in balance; and ensuring accountability of health insurance claims submitted for payment. Time In GradeFederal 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.EducationWhen there is a positive education requirement, or you are using education to qualify as a substitution for experience, transcripts (unofficial) are required at the time of application to verify that you meet the educational requirement or substitution. 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 Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://www2.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.Additional InformationAdditional 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 is earned. This position is covered by a Bargaining Unit. Recruitment or relocation incentives may be authorized. At least a 6 month service agreement will be required. This position has promotion potential to the GS-6 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.