Medical Support Assisant
Major Duties:
Determines patient eligibility for care under the Purchase Referred Care Health Services Program thru established Indian Health Service guidelines. Ensures open documents and pending claims are addressed and that all documents are cleared within time limits. Completes identification, data collection, case preparation, report submissions and follow up on the Service Units Purchase Referred Care Health Services Deferred health Care Case Management Program. Acts as patient advocate to resolve payment questions and payer responsibilities to vendors and providers of contracted and/or non-purchase referred care health care services. 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. For positions requiring positive education requirements, or if you are using education to meet all or part of the qualification requirements, you MUST submit a copy of your transcripts or an itemized list of college courses which includes equivalent information from the transcript (course title, semester/quarter hours, and grade/degree earned) in your resume. MINIMUM
Qualifications:
GS-0679-05:
1 year of specialized experience equivalent to at least 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:
Initiate and distribute authorizations after determining patient eligibility; Contact state agencies to determine medical eligibility within jurisdiction; Maintain files of elective procedures; Schedule admissions; Obtain information regarding patient billing. OR 4 years of education above the high school level. OR Combination of education and experience that when combined fully meet the minimum qualifications for this position. 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-0679-06:
1 year of specialized experience equivalent to at least 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:
Determine patient eligibility as a prerequisite to the authorization of funds; Determine alternate resources available to patients; Conduct personal interviews with patients and/or family members; Maintain an automated system to ensure the accurate accountability of funds; Ensure consistency and correct use of document coding. GS-0679-07:
1 year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:
Perform periodic spot reviews and audits of completed authorization forms; maintain an effective follow up system and maximum utilization of funds; Assure adequate funds are set aside for all authorized referrals; Assure all funds have been obligated; Assure all outstanding authorizations are valid; Assure authorizations are processed. You must meet all qualification requirements within 30 days of the closing date of the announcement. 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).
Estimated Salary: $20 to $28 per hour based on qualifications.
Determines patient eligibility for care under the Purchase Referred Care Health Services Program thru established Indian Health Service guidelines. Ensures open documents and pending claims are addressed and that all documents are cleared within time limits. Completes identification, data collection, case preparation, report submissions and follow up on the Service Units Purchase Referred Care Health Services Deferred health Care Case Management Program. Acts as patient advocate to resolve payment questions and payer responsibilities to vendors and providers of contracted and/or non-purchase referred care health care services. 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. For positions requiring positive education requirements, or if you are using education to meet all or part of the qualification requirements, you MUST submit a copy of your transcripts or an itemized list of college courses which includes equivalent information from the transcript (course title, semester/quarter hours, and grade/degree earned) in your resume. MINIMUM
Qualifications:
GS-0679-05:
1 year of specialized experience equivalent to at least 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:
Initiate and distribute authorizations after determining patient eligibility; Contact state agencies to determine medical eligibility within jurisdiction; Maintain files of elective procedures; Schedule admissions; Obtain information regarding patient billing. OR 4 years of education above the high school level. OR Combination of education and experience that when combined fully meet the minimum qualifications for this position. 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-0679-06:
1 year of specialized experience equivalent to at least 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:
Determine patient eligibility as a prerequisite to the authorization of funds; Determine alternate resources available to patients; Conduct personal interviews with patients and/or family members; Maintain an automated system to ensure the accurate accountability of funds; Ensure consistency and correct use of document coding. GS-0679-07:
1 year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:
Perform periodic spot reviews and audits of completed authorization forms; maintain an effective follow up system and maximum utilization of funds; Assure adequate funds are set aside for all authorized referrals; Assure all funds have been obligated; Assure all outstanding authorizations are valid; Assure authorizations are processed. You must meet all qualification requirements within 30 days of the closing date of the announcement. 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).
- Department:
0679 Medical Support Assistance - Salary Range:
$35,437 to $57,061 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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