Santa Ana Pueblo, NM6 days ago
GS-08: 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: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues. MINIMUM QUALIFICATIONS: GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.