Reimbursable Billing Technician

U.S. Department of Veterans Affairs; Danville (IL); Hybrid; USD 42,000 - 52,000; Full time

Benefits offered by this job

Telework eligible

Full-time schedule

Job summary

U.S. Department of Veterans Affairs (VA) seeks a qualified candidate for a Revenue Cycle position at the North-Central Consolidated Patient Account Center. The role focuses on enhancing revenue through standardized processes and cross-unit collaboration in a multi-location VA Medical Center environment.

Primary duties include validating claims, interpreting insurance policies, and processing Medicare/billing activities. Telework may be authorized; full-time, Mon-Fri schedule applies.

Qualifications

• One year of specialized experience equivalent to GS-5 in revenue-cycle tasks.
• Experience with patient billing, co-payments, and insurance processing.

Responsibilities

• Cooperates with units to solve revenue problems for Veteran accounts.
• Validate billing claims for eligibility and refer questionable coding.
• Interpret third-party policies for billing requirements.
• Submit claims to third-party carriers including Medicare.
• Provide guidance on debt relief options and payment plans.

Skills

Customer service

Billing

Insurance knowledge

Interpreting third party policies

Data entry

Microsoft Excel

Communication

Education

High school diploma or equivalent

Tools

Microsoft Access

Excel

Word

Job description

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.

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.

Qualifications

To apply for this position - you must have the following qualifications: To qualify for this position at the GS-6 level - you must meet the following: SPECIALIZED EXPERIENCE: At least one (1) full year of specialized experience - equivalent to at least the GS-5 grade level - that equipped you with the particular knowledge - skills - and abilities (KSA's) to successfully perform the duties of the position - and that is typically in or related to the work of the position to be filled. Specialized experience is: providing customer service; educating patients; reviews - analyzes - process and completes co-payments and insurance for billing; reviews and processes specialty billing; reviews - analyzes - researches - and verifies insurance policy coverage and filing deadlines. NOTE: 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. For more information on these qualification standards - please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

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.