Contact Representative

MaineGuide; Kittery, Northern (ME, KY); On-site; USD 57,000 - 74,000; Full time

Job summary

MaineGuide is seeking a qualified Contact Representative for the Naval Base Health Clinic Portsmouth in Kittery, Maine. The position supports health benefits inquiries for eligible beneficiaries, including inpatient and outpatient care under USHBP and civilian care under TRICARE.

Candidates will research regulations, interpret information, and provide guidance by phone or written inquiries. The role includes reviewing records, resolving delays, and advising on billing, eligibility, and care

Qualifications

• Specialized Experience: One year of specialized experience which includes: utilizing health information automated systems, verifying insurance benefits for patients, and providing billing or claims information to beneficiaries.

Responsibilities

• Serves as the point of contact on matters relating to health benefits programs available to eligible beneficiaries.
• Researches appropriate regulations and interprets pertinent information for eligible individuals.
• Provides information and assistance based upon personal, written, or telephone inquires concerning both inpatient and outpatient medical care under the USHBP and medical care from civilian sources under the TRICARE program.
• Researches problems in the claims process by telephone or other methods.
• Reviews records and contacts other offices to determine the status of pending actions, the reasons for delays or changes, and what actions or additional information are required to resolve the case.
• Provides information on alternative sources of care, feasibility of treatment option, billing, claims processing, and entitlement.

Skills

Health information systems

Job description

Summary

About the Position: This position is located at Naval Base Health Clinic Portsmouth in Kittery, Maine. Salary negotiation may be available for those candidates who are new to Federal service. Incentives may be available for highly qualified applicants. This is a Direct Hire Solicitation

Learn more about this agency

This job is open to

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Duties

• Serves as the point of contact on matters relating to health benefits programs available to eligible beneficiaries.
• Researches appropriate regulations and interprets pertinent information for eligible individuals.
• Provides information and assistance based upon personal, written, or telephone inquires concerning both inpatient and outpatient medical care under the USHBP and medical care from civilian sources under the TRICARE program.
• Researches problems in the claims process by telephone or other methods.
• Reviews records and contacts other offices to determine the status of pending actions, the reasons for delays or changes, and what actions or additional information are required to resolve the case.
• Provides information on alternative sources of care, feasibility of treatment option, billing, claims processing, and entitlement.

Requirements

Conditions of employment

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment. A background investigation and credit check are required.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
• This position requires the incumbent to have Tuberculosis testing.

Qualifications

Who May Apply: US Citizens

In order to qualify, you must meet the experience requirements described below. 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; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

Specialized Experience: One year of specialized experience which includes: utilizing health information automated systems, verifying insurance benefits for patients, and providing billing or claims information to beneficiaries. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06).

Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone-no substitution of education for experience is permitted.

Additional information

• Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
• You will be required to provide proof of U.S. Citizenship.
• This position may require a 1 year probationary period during which the agency evaluates your fitness and whether your continued employment advances the public interest. In making this determination, the agency may consider your performance and conduct; agency needs and interests; whether your continued employment supports organizational or Government goals; and whether it promotes the efficiency of the Federal service. Continued employment requires written certification that it advances the public interest.
• Direct Deposit of Pay is required.
• Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
• Salary negotiation may be available for those candidates who are new to Federal service.
• Recruitment or relocation incentives MAY be authorized for highly qualified candidates.
• Multiple positions may be filled from this announcement.
• Salary includes applicable locality pay or Local Market Supplement.
• If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
• Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

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.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement. Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.

If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position.

Veterans and Military Spouses will be considered along with all other candidates.

Overview

Accepting applications

Location

1 vacancy in the following location:

Kittery, ME

No matching locations found.

Work site options

Telework eligible

No

Remote job

No

Relocation expenses reimbursed

No

Salary

$57,150 - $74,297 per year

Pay scale & grade

GS 7

Promotion potential

None

Learn more about pay scale and grade

Pay scale and grade determines the salary of the job.

Work schedule

Full-time

Travel Required

Not required

Appointment type

Permanent

Occupations and job series

• 0962 Contact Representative

Supervisory status

No

Federal service type

This job is in the Competitive Service

Represented by a union

No

Drug test

No

Security clearance

Secret

Position sensitivity and risk

Noncritical-Sensitive (NCS)/Moderate Risk

Jobs require a background check and some require a security clearance. The type depends on the job.

Background check type

• Suitability/Fitness

Financial disclosure required

No

Some jobs require financial disclosure to identify conflicts of interests.

Announcement number

HSJT-26-13035238-DHA

Control number

880342400