Reimbursement Specialist - Healthcare jobs in Asheville, NC

Duties

***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, the individual performs assignments of a more limited scope and with less independence. The individual 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. Promotion is not guaranteed, and no promise of promotion is implied.

These duties can include, but are not limited to:

• 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.
• Researches and resolves problems and posts payments, adjustments, denial codes and non-payment collections.
• Performs follow-up on explanation of benefits received from third party carters to maximize revenue and reviews payments to ensure consistency with insurance policy terms.
• 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; monitors reports to assure all possible billable cases are processed.
• Ensures proper sequencing of diagnostic and procedural codes and assigns modifiers as needed.
• 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.
• Perform other related duties as assigned.

Requirements

Conditions of Employment

• You must be a U.S. Citizen to apply for this job
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to background/security investigation
• Selected applicants will be required to complete an online onboarding process
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

How You Will Be Evaluated

• Benefits

  A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

  Review our benefits

  Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

• Required Documents

  As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.

  IMPORTANT: Please ensure your resume include up-to-date contact information (phone number(s), email address(s), etc.)
  
  To apply for this position, you must provide a complete Application Package which includes:
  

  • Resume

  
  
  The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference or ICTAP/CTAP documentation (for displaced Federal employees).
  

  • Cover Letter
  • DD-214/ Statement of Service
  • Disability Letter (VA)
  • Other (1)
  • Other (2)
  • Resume
  • Separation Notice (RIF)
  • SF-15
  • SF-50/ Notification of Personnel Action
  • Transcript

  
  
  Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation, i.e., Letter of Intent, related to your active-duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must refer to the SF-15 "Application for 10 Point Veteran Preference" and submit required documents as applicable and stated on the form. Documentation is mandatory to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.

  If you are relying on your education to meet qualification requirements:

  Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.

  Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

• How to Apply

  All applicants are encouraged to apply online. To apply for this position, you must complete the questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 02/07/2024 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12296852.

  • To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.

  • Click Submit My Answers to submit your application package. NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.

  To verify your application is complete, log into your USAJobs account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.

  Agency contact information

  VHA National Recruitment Center

  Phone

  (844)456-5208

  Email

  VHANationalRecruitmentCenter@va.gov

  Address

  VA MACPAC Asheville 730
  128 Bingham Rd.
  Suite #500
  Asheville, NC 28806
  US

  Next steps

  Once your online application is submitted you will receive a confirmation notification by email. After the vacancy announcement closes, we will review applications per Category Rating procedures to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
  
  You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
  
  NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.

• Fair and Transparent

  The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

  • Equal Employment Opportunity (EEO) Policy
  • Reasonable accommodation policy
  • Financial suitability
  • Selective Service
  • New employee probationary period
  • Signature and false statements
  • Privacy Act
  • Social security number request

Required Documents