Health System Specialist
Summary This position is being re-advertised to solicit additional applications.
Applicants who applied previously need not reapply unless submitting updated and/or missing information.
The position of Health System Specialist is located in the Branch of Business Office Services, Division of Administrative Services, Wind River Service Unit, Ft.
Washakie, Wyoming.
Position reports to the Deputy Chief Executive Officer or designee.
Responsibilities Direct the third party reimbursement program and subordinate staff.
Monitor, analyze and conduct periodic audits of the reimbursement system to ensure timely, accurate and proper billing and collection of claims from third party insurances.
Respond to correspondence generated by third party insurance carriers to assure maximum collection on submitted bills.
Use automated system to:
run reports to identifying billing backlog, accounts receivable of revenue from third party claims, etc.
.
Keep abreast of latest national, federal, and state statutes, rules, regulations and policies on business office billing concepts, products, materials, information and trends.
This position will support the Federal Government's response efforts to COVID-19.
Requirements Conditions of Employment Selectee may be subject to a probationary/trial period ESEP appointees typically serve a two year trial period U.
S.
Citizenship is required Selective Service Registration is required for males born after 12/31/1959 This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children.
Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
A one-year supervisory/managerial probationary period may be required upon selection/placement.
Measles and Rubella immunization required for selectees born after 1957.
Seasonal Influenza immunization is required for civilian health care facility staff working in Indian Health Service health care facilities.
Successfully pass the E-Verify employment verification check.
To learn more about E-Verify, including your rights and responsibilities, visit www.
dhs.
gov/E-Verify/.
Selectee is required to have a viable bank account at a financial institution for electronic direct deposit of salary payment.
Background Investigation:
If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation.
Fingerprint results and background investigation documentation must be cleared prior to hire.
After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position.
The investigation must find that you are suitable for Federal employment in your position.
If you are found not suitable, you will be terminated after you begin work.
If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges.
You may be subject to a credit check as a part of the background investigation process.
Qualifications 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.
INDIVIDUAL OCCUPATIONAL REQUIREMENTS:
Undergraduate and Graduate Education:
Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.
OR Specialized
Experience:
(for positions above GS-5):
Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field.
This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities.
Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following:
-Missions, organizations, programs, and requirements of health care delivery systems; -Regulations and standards of various regulatory and credentialing groups; and -Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
MINIMUM
Qualifications:
GS-11:
Ph.
D.
or equivalent doctoral degree; or 3 full years of progressively higher level graduate education leading to such a degree; or LL.
M.
, if related OR your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:
Comprehensive responsibilities as a supervisor to include:
direct the activities of the Accounts Receivable and/or Denial/Accounts Management functions, perform long and short range planning, evaluation, and analysis; and projection of future resource requirements, personnel administration, provide training, development, and orientation of new and existing employees, and continuous quality improvement; Perform a variety of accounts receivable and denial/accounts management functions such as:
examination, verification and maintenance of data involved in processing payments, denials and partial payments from alternate resources; determine the eligibility of patients; Identify and analyze issues, problems and challenges facing the revenue cycle management; Evaluate and compile data of denied claims and analyzes status reports for review to Management.
Time In Grade 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).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education There are no education requirements.
Additional Information Additional selection(s) of candidates may be possible within 90 days from the date the certificate of eligibles was issued for this announcement.
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee.
IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service.
This credited service can be used in determining the rate at which they earn annual leave.
This position meets the criteria specified in pillar number one of the five pillars of the PHS Commissioned Corps.
PHS Commissioned Officers interested in performing the duties of this position within the Commissioned Corps MUST apply online under the merit promotion announcement indicated above in order to receive consideration.
For more information on PHS Commissioned Corps, visit the website at:
https:
//www.
usphs.
gov/.
This position has no promotion potential.
This position is not covered by a Bargaining Unit.
Recruitment or relocation incentives may be authorized.
At least a 6 month service agreement will be required.
Recommended Skills Accounts Receivable Administration Analytical Auditing Billing Claim Processing Estimated Salary: $20 to $28 per hour based on qualifications.
Applicants who applied previously need not reapply unless submitting updated and/or missing information.
The position of Health System Specialist is located in the Branch of Business Office Services, Division of Administrative Services, Wind River Service Unit, Ft.
Washakie, Wyoming.
Position reports to the Deputy Chief Executive Officer or designee.
Responsibilities Direct the third party reimbursement program and subordinate staff.
Monitor, analyze and conduct periodic audits of the reimbursement system to ensure timely, accurate and proper billing and collection of claims from third party insurances.
Respond to correspondence generated by third party insurance carriers to assure maximum collection on submitted bills.
Use automated system to:
run reports to identifying billing backlog, accounts receivable of revenue from third party claims, etc.
.
Keep abreast of latest national, federal, and state statutes, rules, regulations and policies on business office billing concepts, products, materials, information and trends.
This position will support the Federal Government's response efforts to COVID-19.
Requirements Conditions of Employment Selectee may be subject to a probationary/trial period ESEP appointees typically serve a two year trial period U.
S.
Citizenship is required Selective Service Registration is required for males born after 12/31/1959 This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children.
Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
A one-year supervisory/managerial probationary period may be required upon selection/placement.
Measles and Rubella immunization required for selectees born after 1957.
Seasonal Influenza immunization is required for civilian health care facility staff working in Indian Health Service health care facilities.
Successfully pass the E-Verify employment verification check.
To learn more about E-Verify, including your rights and responsibilities, visit www.
dhs.
gov/E-Verify/.
Selectee is required to have a viable bank account at a financial institution for electronic direct deposit of salary payment.
Background Investigation:
If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation.
Fingerprint results and background investigation documentation must be cleared prior to hire.
After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position.
The investigation must find that you are suitable for Federal employment in your position.
If you are found not suitable, you will be terminated after you begin work.
If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges.
You may be subject to a credit check as a part of the background investigation process.
Qualifications 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.
INDIVIDUAL OCCUPATIONAL REQUIREMENTS:
Undergraduate and Graduate Education:
Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.
OR Specialized
Experience:
(for positions above GS-5):
Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field.
This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities.
Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following:
-Missions, organizations, programs, and requirements of health care delivery systems; -Regulations and standards of various regulatory and credentialing groups; and -Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
MINIMUM
Qualifications:
GS-11:
Ph.
D.
or equivalent doctoral degree; or 3 full years of progressively higher level graduate education leading to such a degree; or LL.
M.
, if related OR your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:
Comprehensive responsibilities as a supervisor to include:
direct the activities of the Accounts Receivable and/or Denial/Accounts Management functions, perform long and short range planning, evaluation, and analysis; and projection of future resource requirements, personnel administration, provide training, development, and orientation of new and existing employees, and continuous quality improvement; Perform a variety of accounts receivable and denial/accounts management functions such as:
examination, verification and maintenance of data involved in processing payments, denials and partial payments from alternate resources; determine the eligibility of patients; Identify and analyze issues, problems and challenges facing the revenue cycle management; Evaluate and compile data of denied claims and analyzes status reports for review to Management.
Time In Grade 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).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education There are no education requirements.
Additional Information Additional selection(s) of candidates may be possible within 90 days from the date the certificate of eligibles was issued for this announcement.
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee.
IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service.
This credited service can be used in determining the rate at which they earn annual leave.
This position meets the criteria specified in pillar number one of the five pillars of the PHS Commissioned Corps.
PHS Commissioned Officers interested in performing the duties of this position within the Commissioned Corps MUST apply online under the merit promotion announcement indicated above in order to receive consideration.
For more information on PHS Commissioned Corps, visit the website at:
https:
//www.
usphs.
gov/.
This position has no promotion potential.
This position is not covered by a Bargaining Unit.
Recruitment or relocation incentives may be authorized.
At least a 6 month service agreement will be required.
Recommended Skills Accounts Receivable Administration Analytical Auditing Billing Claim Processing Estimated Salary: $20 to $28 per hour based on qualifications.
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