Claims Assistant (Office Automation) - Indian Health Service

Summary The position is at an ambulatory health care center. Performs clerical and record keeping for medical referral, i.e. sending a patient by health care professional to outside referrals for diagnostic testing, medical specialists. We are accepting applications year-round with eligible applicants being placed on a standing register and referred for consideration as vacancies occur. Referral is based on the date management request is received. Recruitment or relocation incentives may be offered. Responsibilities Take application for assistance Review application for completeness Collect eligibility data Type addressograph (name) plates and impresses on authorizations Tabulate commitment registers, assembles Mail (pre-designed) PRC orientation packets Maintains individual patient and program general files. Requirements Conditions of Employment Selectee may be subject to a probationary/trial period ESEP appointees typically serve a two year trial period 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. Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities. COVID-19 vaccination is required for all selectees prior to entrance on duty. Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/. You will need to set up direct deposit so we can pay you. Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process. Qualifications 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-0998-04 Your resume must demonstrate at least one (1) year of general experience equivalent to at least the grade GS-03, which is 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 such as work experience in applying, established rules, processes, and procedures in examining claims. Tasks similar to following examples are qualifying: examine applications for benefits or claims submitted by a claimant when they arrive in the office, verify that routine items, such as the identity of the claimant are on the document, return incomplete applications to the applicant with a form requesting additional information, consolidate claims files or related folders, and review official records in the agency records center to verify information on applications. OR Submit a copy of unofficial transcripts to show 2 years education above the high school level. Successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5. NOTE: Equivalent combinations of education and experience are qualifying for all grade levels and positions for which both education and experience are acceptable. OR Demonstrate meeting qualifications for this grade level by indicating on resume and submitting a copy of unofficial transcripts to show a combination of general experience and education post high school with courses related to the occupation that meets 100% of the qualification requirements for this position. General Experience is progressively responsible clerical, office, or other work that indicates ability to acquire the particular knowledge and skills needed to perform the duties of the position to be filled. MINIMUM QUALIFICATIONS, GS-0998-05. Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the grade GS-04, which is 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 such as work experience in applying, specialized rules, processes, and procedures in examining claims such as reviewing claims for medical procedures or similar types of claims. Examples of tasks for this level includes reviewing claims and correcting amounts for allowable items, use information furnished by the claimants to determine the appropriate provisions under which claims should be submitted and the nature and amount of supporting evidence required to process the claim, assist claimants in preparing supporting evidence, examine files, determines allowable items, and calculate the correct amounts for allowed items. OR Submit a copy of unofficial transcripts to show 4 years of education above the high school level. Successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5 OR Demonstrate meeting qualifications for this grade level by indicating on resume and submitting a copy of unofficial transcripts to show a combination of specialized experience and above high-school education that meets 100% of the qualification requirements for this position. NOTE: Equivalent combinations of education and experience are qualifying for all grade levels and positions for which both education and experience are acceptable. Specialized Experience refers to experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform successfully the duties of the position, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level. Proficiency Requirements: This position requires the skill of a qualified typist. In addition to meeting experience or education requirements, you must be able to type at least 40 words per minute (based on a 5-minute sample with 3 or fewer errors). All candidates must self-certify their typing ability when completing the occupational questionnaire. 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 cut-off date or the closing date of the announcement. Cut-off date(s) are established based on the date the human resources office receives management request for a list of eligibles or every 5 days thereafter. The job announcement is open continuous until the closing date. Education Successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5 for this position. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. Additional Information Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed. This position is eligible for workplace flexibilities which may include remote work or telework options, and/or flexible work scheduling. These flexibilities may be requested in accordance with the HHS Workplace Flexibilities policy. https://www.hhs.gov/about/agencies/asa/ohr/hr-library/990-1/index.html. Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. 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. This position has promotion potential to the GS-05 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.