Health Insurance Technician

Summary

About the Position: This position is located at Walter Reed National Military Medical Center (WRNMMC) in Bethesda, MD. Work is performed in an office setting. Core operating hours are 0600-1800, with any eight-hour shift scheduled within that span. This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD to recruit and appoint qualified candidates to positions in the competitive service.

Duties

• Manage and reconcile patient accounts and claims.
• Provide technical oversight and quality control.
• Ensure accurate billing, collections, and audit trails for reimbursable earnings.
• Review, challenge, and analyze insurance payments and denials to maximize reimbursement.
• Improve and support the Medical Services Accounts (MSA) program and systems.
• Review and validate encounters for billing eligibility, accuracy, and completeness.
• Resolve claims issues and ensure follow-up on unpaid/denied bills.
• Post and reconcile insurance payments, and support billing system operations.
• Utilize knowledge of hardware (servers, printers, monitors, hard drives, etc.), software, and networking to ensure continuous electronic billing and integration with other medical information systems.

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 working with insurance companies regarding billings or payments; documenting transactions, identifying discrepancies to provide solutions; and working with automated healthcare or financial systems such as: Genesis, Revenue Cycle, Account Receivables Management System, Armed Forces Billing and Collection Utilization Solution (ABACUS). 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.

How You Will Be Evaluated

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. Other 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 requires 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. 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.