About this role
Job Summary
About the Position
This position is located at Evans Army Community Hospital, Fort Carson, Colorado This is a Direct Hire Solicitation.
A recruitment or relocation incentive MAY be authorized. Salary negotiation MAY be available for those candidates who are new to Federal service. Non-Federal work experience MAY be creditable for leave purposes. Student Loan repayment MAY be authorized
Qualifications
Who May Apply: US Citizens In order to qualify, you must meet the 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. Additional information about transcripts is in this document.
Basic Requirement for Contact Representative: Specialized Experience: One year of specialized experience which includes: utilizing health information automated systems, verifying insurance benefits for patients, and providing billing or claims information to beneficiaries. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06).
Major Duties
- Serve as the point of contact on matters relating to health benefits programs available to eligible beneficiaries.
- Research appropriate regulations and interprets pertinent information for eligible individuals.
- Provide information and assistance based upon personal, written, or telephone inquires concerning both inpatient and outpatient medical care under the USHBP and medical care from civilian sources under the TRICARE program.
- Research problems in the claims process by telephone or other methods.
- Review records and contacts other offices to determine the status of pending actions, the reasons for delays or changes, and what actions or additional information are required to resolve the case.
- Provide information on alternative sources of care, feasibility of treatment option, billing, claims processing, and entitlement.