What are the responsibilities and job description for the Medical Affirmative Claims Technician with Security Clearance position at Department of Defense?
Duties
- Responsible for identifying potential third party recovery actions by reviewing various medical records, reports, and media sources.
- Establish and implement procedures in accordance with applicable Service regulations to facilitate the exchange of information necessary to support Medical Affirmative Recovery activities.
- Research Medical Data Registry for proof of eligibility, verifying appointments and proper coding of each clinic visit and admission.
- Research and follow up with all types of contacts based on medical third party insurance or medical coverage.
- Generate medical claims forms with accurate cost computation.
- Conduct research on radiology, laboratory, and pharmacy charges for additional billing needs.
Requirements - Conditions of Employment:
- The position is designated as Mission Essential. The incumbent will be required to report to work during times of contingency operations, natural disasters, extreme weather or other emergency situations.
- This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment.
- This position has a mandatory seasonal influenza vaccination requirement and is therefore subject to annual seasonal influenza vaccinations.
- This position requires to obtain and maintain a Financial Management Level 1 Certification within 24 months of employment.
Qualifications:
To qualify for this position, 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.
Addition information about transcripts is in this document.
Specialized Experience:- One year of specialized experience which includes experience researching medical records to determine billable encounters; and experience generating medical claims; and experience researching medical records.
This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-6).
Education: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.
Additional information:
Who May Apply:- US Citizens
Veterans & Military Spouses:
Information regarding special hiring authorities for veterans and military spouses can be found
