Financial Accounts Technician
Duties include but may not be limited to the following:
Serves as the Outpatient Pharmacy Electronic Claims Coordinator (OPECC) and is responsible for the billing insurance verification functions and account follow-up as they pertain to the e-Pharmacy program for all medical centers serviced by the Consolidated Patient Account Center (CPAC). Acts as the liaison for the CPAC, Medical Center CPAC Staff, and Medical Center Pharmacy, to resolve issues or problems with electronic submission and to maximize collections. Performs claims submission functions related to prescription drugs provided for beneficiaries with reimbursable prescription insurance. Provides expertise on claim submission actions, ensuring claims are submitted in various formats in compliance with specific requirements of the appropriate insurance carrier. Reviews returned/rejected claims for reason for rejection or denial, taking appropriate corrective action, and resubmits claims for payment. Assumes responsibility for the collection functions of the Revenue program third party insurance pharmacy reimbursements. Researches and processes refund requests from third party pharmacy payers. Assesses workload daily, establishing priorities to facilitate the timely and appropriate completion of all assigned tasks. Solves problems that may arise with electronic submission of pharmacy claims, including insurance verification, patient accounts and data validation. Performs other duties as assigned. Work Schedule:
Monday to Friday - 8am to 4;30pm Recruitment & Relocation Incentives:
Not authorized Financial Disclosure Report:
Not Required SPECIALIZED
Experience:
MUST one (1) year of specialized experience equipped with the knowledge, skill, and abilities to perform the duties of the Financial Accounts Technician position. To be creditable, this experience must have been equivalent to at least the GS-5 grade level in the Federal Service. Specialized experience includes:
working experience performing collection functions of a revenue program third party insurance pharmacy reimbursements; performing collections, technician reviews, researches and analyzes account receivable records by utilizing various databases; performing various levels of analyses such as reviewing patient claim history for previous payments, determining payer requirements and comparing to potential billable encounters, examining possible acquisition of retro-authorizations to ensure collections, considering timely-filing requirements for billing feasibility,developing and validating data to successfully resubmit claims to acquire payment;actively contacts and pursues third-party payers to expedite collections; tracking third-party payments posted to suspense and coordinates appropriate and timely resolution of these suspense payments with other departments. (This experience must be documented in your resume) You will be rated on the following Competencies as part of the assessment questionnaire for this position:
Accounting OperationsAnalytical ThinkingDatabase AdministrationInsurance IMPORTANT:
A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. 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). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https:
//www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
Estimated Salary: $20 to $28 per hour based on qualifications.
Serves as the Outpatient Pharmacy Electronic Claims Coordinator (OPECC) and is responsible for the billing insurance verification functions and account follow-up as they pertain to the e-Pharmacy program for all medical centers serviced by the Consolidated Patient Account Center (CPAC). Acts as the liaison for the CPAC, Medical Center CPAC Staff, and Medical Center Pharmacy, to resolve issues or problems with electronic submission and to maximize collections. Performs claims submission functions related to prescription drugs provided for beneficiaries with reimbursable prescription insurance. Provides expertise on claim submission actions, ensuring claims are submitted in various formats in compliance with specific requirements of the appropriate insurance carrier. Reviews returned/rejected claims for reason for rejection or denial, taking appropriate corrective action, and resubmits claims for payment. Assumes responsibility for the collection functions of the Revenue program third party insurance pharmacy reimbursements. Researches and processes refund requests from third party pharmacy payers. Assesses workload daily, establishing priorities to facilitate the timely and appropriate completion of all assigned tasks. Solves problems that may arise with electronic submission of pharmacy claims, including insurance verification, patient accounts and data validation. Performs other duties as assigned. Work Schedule:
Monday to Friday - 8am to 4;30pm Recruitment & Relocation Incentives:
Not authorized Financial Disclosure Report:
Not Required SPECIALIZED
Experience:
MUST one (1) year of specialized experience equipped with the knowledge, skill, and abilities to perform the duties of the Financial Accounts Technician position. To be creditable, this experience must have been equivalent to at least the GS-5 grade level in the Federal Service. Specialized experience includes:
working experience performing collection functions of a revenue program third party insurance pharmacy reimbursements; performing collections, technician reviews, researches and analyzes account receivable records by utilizing various databases; performing various levels of analyses such as reviewing patient claim history for previous payments, determining payer requirements and comparing to potential billable encounters, examining possible acquisition of retro-authorizations to ensure collections, considering timely-filing requirements for billing feasibility,developing and validating data to successfully resubmit claims to acquire payment;actively contacts and pursues third-party payers to expedite collections; tracking third-party payments posted to suspense and coordinates appropriate and timely resolution of these suspense payments with other departments. (This experience must be documented in your resume) You will be rated on the following Competencies as part of the assessment questionnaire for this position:
Accounting OperationsAnalytical ThinkingDatabase AdministrationInsurance IMPORTANT:
A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. 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). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https:
//www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
- Department:
0503 Financial Clerical And Assistance - Salary Range:
$37,223 to $48,385 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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