Voucher Examiner
Examines vouchers, invoices, claims, and other requests for payment of healthcare services delivered to patients and family members; Analyzes each voucher to determine propriety of payment; Reviews all claims to ensure necessary processing information is present; Reviews claims for payment or reimbursement for medical and ambulance service; Examines accounts and/or resolves difficult reconciliations requiring an analysis of adjustments and corrective entries in the account; Performs ancillary preparatory components of other health insurance resolution responsibilities; Utilizes knowledge of financial and accounting systems and regulations, reconciliation, and Health Care Financing Administration Common Procedural Coding System (HCPCS). Promotion Potential:
The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule:
Monday-Friday, 8:
00 am - 4:
30 pm Compressed/Flexible:
Not Available Telework:
Not Available Virtual:
This is not a virtual position. Position Description/PD#:
Voucher Examiner/PD03365A and PD03247A Relocation/Recruitment Incentives:
Not Authorized Financial Disclosure Report:
Not required To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/31/2020. Time-In-Grade Requirement GS-6:
Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-06 position you must have served 52 weeks at the GS-05. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. You may qualify based on your experience and/or education s described below:
Specialized Experience GS-5:
You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Makes determinations on health care claims based on legal entitlement specific to the circumstances involved. Checks for accuracy and adequacy of documentation for customers regarding healthcare treatment. Verifies claims for payments or reimbursements. Interprets rules, regulations, and laws regarding treatment and eligibility. Enters payment information into a centralized automated system. OR, GS-05 Applicants may substitute education for the required experience (TRANSCRIPTS REQUIRED):
You must possess Four (4) years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. OR, GS-05:
Combination of Education and Experience (TRANSCRIPTS REQUIRED):
You must possess a combination of successfully completed education and experience to meet the total experience requirements. (i.e. 6 months of specialized experience and 3 years of education above the high school level). NOTE:
Only education beyond the second year can be used in combination with specialized experience to qualify for this grade. Specialized
Experience:
You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Knowledge of financial/accounting systems, Reconciliation on accounts, Resolving issues surrounding payment and denials of healthcare claims. Makes determinations on health care claims based on legal entitlement specific to the circumstances involved. Checks for accuracy and adequacy of documentation for customers regarding healthcare treatment. You will be rated on the following Competencies for this position:
InsuranceTechnical CompetenceTechnology Application 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note:
A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements:
The work is primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort. 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/.
Estimated Salary: $20 to $28 per hour based on qualifications.
The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule:
Monday-Friday, 8:
00 am - 4:
30 pm Compressed/Flexible:
Not Available Telework:
Not Available Virtual:
This is not a virtual position. Position Description/PD#:
Voucher Examiner/PD03365A and PD03247A Relocation/Recruitment Incentives:
Not Authorized Financial Disclosure Report:
Not required To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/31/2020. Time-In-Grade Requirement GS-6:
Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-06 position you must have served 52 weeks at the GS-05. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. You may qualify based on your experience and/or education s described below:
Specialized Experience GS-5:
You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Makes determinations on health care claims based on legal entitlement specific to the circumstances involved. Checks for accuracy and adequacy of documentation for customers regarding healthcare treatment. Verifies claims for payments or reimbursements. Interprets rules, regulations, and laws regarding treatment and eligibility. Enters payment information into a centralized automated system. OR, GS-05 Applicants may substitute education for the required experience (TRANSCRIPTS REQUIRED):
You must possess Four (4) years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. OR, GS-05:
Combination of Education and Experience (TRANSCRIPTS REQUIRED):
You must possess a combination of successfully completed education and experience to meet the total experience requirements. (i.e. 6 months of specialized experience and 3 years of education above the high school level). NOTE:
Only education beyond the second year can be used in combination with specialized experience to qualify for this grade. Specialized
Experience:
You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Knowledge of financial/accounting systems, Reconciliation on accounts, Resolving issues surrounding payment and denials of healthcare claims. Makes determinations on health care claims based on legal entitlement specific to the circumstances involved. Checks for accuracy and adequacy of documentation for customers regarding healthcare treatment. You will be rated on the following Competencies for this position:
InsuranceTechnical CompetenceTechnology Application 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note:
A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements:
The work is primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort. 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/.
- Department:
0540 Voucher Examining - Salary Range:
$36,456 to $52,833 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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