Health Systems Specialist (Provider Enrollment Specialist)

Description:

This position is located at the Phoenix Indian Medical Center (PIMC), Division of Financial Services, Patient Business Services in Phoenix, Arizona. The position serves as the Provider Enrollment Specialist responsible for initiating provider and facility enrollment applications for Centers for Medicare and Medicaid Services (CMS), Arizona Medicaid (AHCCCS), California Medicaid (Medi-Cal), Nevada Medicaid, New Mexico Medicaid, and various private insurance or managed care plans.

Requirements:

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.

INDIVIDUAL OCCUPATIONAL REQUIREMENTS: G raduate 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 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 MINIMUM QUALIFICATIONS: GS-0671-09:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-07 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience within the Patient Registration department who is responsible for the evaluation and reporting and performs liaison functions with contract providers, state and local agencies; Served as a facility or provider authorized organizational official to review and complete CMS, state Medicaid, private insurance, and managed care applications; Assists and supports medical staff to complete state Medicaid attestation and registration process; Analyzes and evaluates (on a quantitative or qualitative basis) the effectiveness of program operations; Maintain and ensures provider and facility numbers for insurance and billing purposes are current.

OR

Master's or equivalent graduate degree

OR

Completion of 2 full years of progressively higher level graduate education leading to such a degree.

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 closing date of the announcement.