About the Position: Serve as a Financial Specialist for the Defense Health Agency (DHA), Naval Health Clinic Patuxent River in Patuxent River, MD. This is a Direct Hire Solicitation

Duties

Analyze, review, and research data obtained in the current medical records, dental records, and billing systems to identify billable encounters. Ensure new and current patients’ insurance information is received, verified, and validated with third party payers or other health insurance parties. Identify and process preauthorization requests to third party payers and insurance companies. Provide an explanation of benefits (EOB) on how insurance claims are being processed; and work directly with payers to determine problems, resolve issues, and initiate resolution of debt. Identify and review accounts with over payments; submit refunds with audit trail and breakdowns per fiscal year. Ensure complete documentation of claims are filed, follow-ups are settled, and additional developmental actions are finalized and closed to satisfy record audits.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position is designated as moderate to high risk involving Public Trust. Appointment to this position is subject to a background investigation including a credit check to determine suitability for Federal employment and/or the position.
• This position may require 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.
• This position has mandatory seasonal influenza vaccination requirements and is subject to annual seasonal influenza vaccinations unless otherwise exempted for medical or religious reasons (documentation of exemption must be provided upon hire).
• This is a DOD Financial Management position. The incumbent must complete training and meet position requirements for certification at Level 2 within 2 years of appointment.
• Incumbent is required to submit a Financial Disclosure Statement, SF-278, (5CFR Part 2634, Subpart B USOGE, 11/04), Executive Branch Personnel Public Financial Disclosure Report upon entering the position and annually.

Qualifications

Who May Apply: US Citizens In order to qualify, you must meet the education and/or 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. Basic Requirements for Financial Specialist: Specialized Experience: One year of specialized experience which includes billing insurance companies and collecting payments; reviewing and managing accounts receivable and accounts payable; and following up on delinquent claims. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-07). OR Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. (You must attach a copy of your transcripts with your application package.) OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages. (You must attach a copy of your transcripts with your application package.)

Education

FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address JT-DHA-DD83DR DHA NCR MKT-NHC PATUXENT RIVER DO NOT MAIL Patuxent River, MD 20670 US
• Name: Army Applicant Help Desk