Health System Specialist

Indian Health Service • Anchorage, AK

1d

About The Position

This position is located in the Business Office (BO) Program, Office of Administrative Support. Coordinates operations across distinct reimbursement programs-Medicare, Medicaid, Private Insurance, Children's Health Insurance Program, and Veterans Affairs-maintaining and improving the reimbursement system in compliance with the Resource Operations Manual and other applicable rules and regulations. Serves as principal advisor to the Director of Revenue and other Area program managers on Business Office matters, and as the primary point of contact for Billings Area programs and staff on third-party reimbursement issues. Serves as system manager for all Resource and Patient Management System (RPMS) Business Office applications, including Patient Registration, Third Party Billing, and Accounts Receivable. Establishes and maintains liaison with community, tribal, state, and federal agencies and professional organizations-including IHS Headquarters, CMS Regional Centers, State Medicaid offices, fiscal intermediaries, and billing clearinghouses-to plan program priorities and policy, and ensures Area and Service Unit compliance with IHS and federal statutes and regulations.

Requirements

• U.S. Citizenship is required
• Selective Service Registration is required for males born after 12/31/1959
• This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
• Successfully pass the E-Verify employment verification check.
• Background Investigation Requirement: This position requires the successful completion of a federal background investigation as a condition of employment.
• Financial Suitability Requirement: This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying. Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).
• Prior to the appointment, candidates must present two valid forms of identification. If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant.
• Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.
• OR Specialized Experience Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
• In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below.
• MINIMUM QUALIFICATIONS: 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: Experience in working with a multi-disciplinary team to achieve the goals of the health care centers, provide consultative assistance and guidance daily to health centers regarding proper billing procedures, patient eligibility for services, patient registration, benefit coordination, interpretation of guidance, monitoring and analyzing collections and irregularities in billing information received.
• 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.

Nice To Haves

• If you are substituting education for experience; You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades.
• If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education.

Responsibilities

• Coordinates operations across distinct reimbursement programs-Medicare, Medicaid, Private Insurance, Children's Health Insurance Program, and Veterans Affairs-maintaining and improving the reimbursement system in compliance with the Resource Operations Manual and other applicable rules and regulations.
• Serves as principal advisor to the Director of Revenue and other Area program managers on Business Office matters, and as the primary point of contact for Billings Area programs and staff on third-party reimbursement issues.
• Serves as system manager for all Resource and Patient Management System (RPMS) Business Office applications, including Patient Registration, Third Party Billing, and Accounts Receivable.
• Establishes and maintains liaison with community, tribal, state, and federal agencies and professional organizations-including IHS Headquarters, CMS Regional Centers, State Medicaid offices, fiscal intermediaries, and billing clearinghouses-to plan program priorities and policy, and ensures Area and Service Unit compliance with IHS and federal statutes and regulations.

Benefits

• Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Health System Specialist Total Compensation | Pay (ihs.gov)
• Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee.
• IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
• Recruitment or relocation incentives may be authorized.
• At least a 6 month service agreement will be required.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed