This position will report to the Supervisory Health System Specialist of the Patient Registration/Patient Benefit Department, Business Office, Division of Administrative Services. The primary purpose of this position is to provide registration and eligibility services which are the key points of interaction with patients to obtain and process demographic and insurance information for alternate resources, Purchased Referred Care Services, and private and commercial insurance.
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. MINIMUM QUALIFICATIONS: GS-04: One (1) year of general experience (General experience: Progressively responsible clerical, office or other work that indicates ability to perform the work of this position.); OR, Two (2) years above high school. OR a combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage must equal at least 100% to qualify an applicant for GS-4 level. GS-05: One (1) year of specialized experience equivalent to at least the GS-04 grade level; OR, Four (4) years above high school. GS-06: One (1) year of specialized experience equivalent to at least the GS-05 grade level; education generally, not applicable. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. 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: GS-05: Specialized Experience - Interview patient to obtain personal demographic information, assist patient with form completion, determine eligibility for alternate resources for health care, verify information into electronic health record, scan and file information into electronic health record, enter patient demographic and insurance information into an automated patient registration system; greets patients and their family members, answer questions, apply state laws concerning vital statistic records and birth/death certificates. GS-06: Specialized Experience - In addition to the above GS-05, able to organize patient records, extract medical information and review records for completeness, accuracy, and consistency with medical facility requirements; record data involving patient appointments, admissions and discharge/transfer information using the medical facility's automated and/or manual medical records system; respond to changing priorities that frequently depend upon the urgency of the situation. 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.
Interviews patients and/or family members to obtain pertinent and accurate patient registration information. Obtains photocopies of legal documents regarding adoption, power of attorney and name changes. Operates personal computers, data processing equipment, and/or office support software for different types of word processing, data entry, or data retrieval; uses grammar, spelling, punctuation, and required formats. Assists patients in completing new or updated forms, explains and obtains signatures for file on required form(s), such as Medicare Secondary Payer form, Assignment of Benefits form, HIPAA/Privacy Act forms, and Notification to provide Certificate of Indian Blood, prior to clinic services for billing purposes and/or Contract Health Services eligibility. Completes admissions forms for scheduled admissions from information provided by the patient and by the referring provider. Processes admissions to the medical center embossing various documents for distribution to designated services, referring patients to assigned wards and giving individual instructions to patients. Adheres to Privacy Act of 1974 and the use of confidential information and health records as an integral part of the interviewing office function and the privacy of individuals which must be protected to the fullest extent possible. Maintains, verifies, key-enters, and updates alternate data necessary for accurate billing using the current patient registration database system. Obtains third party coverage information; collects and photocopies health insurance cards. Verifies eligibility by contacting the Social Security Administration, Railroad Retirement communicates and assists board, Income Support Division, Department of Economic Security, State Medicaid Offices and private/commercial insurance companies. Obtains prior authorization for care to enable the billing section for billing purposes for healthcare services received for Indian and/or Non-Indian beneficiaries; identifies and refers potentially eligible patients to the Contact Representative. Ensures patient understands the fair entitlement of IHS/non IHS facilities; explains the program to the patients, such as reasons for need of Medicare/Medicaid and/or private/commercial insurance. Communicates and assists Contact Representatives in obtaining pre-screens and/or applications; review appointment listing the day before appointment date; determines which patient need referring to Contact Representative.