Summary
This position is located in the North-Central Consolidated Patient Account Center at the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), VA Medical Center, in multiple locations. The primary purpose of this position is to perform a variety of functions, including enhancing revenue, using an industry best model built on regional management of key aspects of the revenue cycle, process standardization, accountability, and economies of scale.
Duties
***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** Major duties and responsibilities will include: Cooperates with personnel within other organizational units in the wider employing organization to solve revenue problems applicable to Veteran accounts. Validating claims for billing purposes ensuring eligibility and referring questionable coding for review. Interpreting third party insurance policies and requirements for billing. Submitting claims to third party health insurance carriers, with knowledge of Medicare coverage benefits. Taking responsibility for Medicare reimbursable billing activities. Obtains data and other information from VA-specific change notifications and ad-hoc reports to proactively or retroactively correct 1st and 3rd party billing. Reviews for accuracy, adequacy of the documentation, compliance with regulations, and the justification of the action Following instructions about timeliness, objectives, and relative priorities for doing work. Exhibiting flexibility in adapting to changing demands within specific timelines. Receives workload from multiple worklist systems, electronic and mail notifications, VA specific internal and external data applications, emails, letters, and face-to-face customer service interactions. Accepting and completing work provided by a standardized control system such as batched work, caseload level, or other defined structure. Handling conflicting goals, objectives, priorities, timelines, and deadlines. Using a wide range of office software applications such as Microsoft Access, Excel, and Word. Composing correspondence on a situational basis. Analyzes each voucher or invoice to determine propriety of payment to include required certifications by authorized officials, compliance with contract provisions, price agreements, and/or other directives. Conducts analysis to develop required data and information reporting purposes and drafts brief factual administrative reports. Performs daily reviews, audits, and/or corrective actions in response to workload activities or requests received directly from Veteran customers, Office of General Counsel, internal and/or external compliance and quality measurement and performance teams, and the VA Office of the Inspector General (OIG). Provides accurate and proficient guidance to all customer groups regarding debt relief options such as formal repayment plans and waivers and interpreting insurance policy coverages, VA eligibility benefits, and other factors that impact Veteran financial accounts for both 1st and 3rd Party billing. Performs other duties as assigned Work Schedule: Monday - Friday; Full - Time, 8:00am - 4:30pm Recruitment Incentive: May be authorized for highly qualified candidates Critical Skills Incentive (CSI): Not approved Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process.
Requirements
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 required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. 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 (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's 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. As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: 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. Upon completion of your probationary, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Education
There is no educational substitution at this grade level. NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
How you will be evaluated
Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics): Arithmetic/Mathematical Reasoning Customer Service Flexibility Integrity/Honesty Interpersonal Skills Reasoning Teamwork Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. Candidates who apply under "All U.S. Citizens" announcements will be rated and ranked using Category Rating procedures. Qualified candidates will be assigned to a quality category. The categories are defined as follows: Best qualified - Applicants possessing the type and quality of experience that substantially exceeds the minimum qualifications Very Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a very considerable extent, the minimum qualifications Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a considerable extent, the minimum qualifications Well qualified - Applicants possessing the type and quality of experience that marginally exceeds the minimum qualifications of the position and who demonstrate average proficiency in most of the critical competencies Qualified - Applicants possessing the type and quality of experience that meets the minimum qualifications Application of Veterans' Preference: Category rating and selection procedures place those with veteran's preference above non-preference eligibles within each category. Preference eligible applicants that meet the eligibility and qualification requirements and who have a compensable service-connected disability of at least 10 percent are listed in the highest quality category (except when the position being filled is scientific or professional at the GS-09 grade level or higher). 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; 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.