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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. Developmental/multi-graded: Management may select at any of the grade levels announced. Duties described reflect the full performance GS-08 level. Duties will be performed in a developmental capacity under close supervision. This recruitment provides promotion opportunity to the target grade of the position without further competition when selectee is eligible and recommended by management. GS-6 Grade Level: Specialized Experience: One year of specialized experience which includes 1) perform referral screening and appointing for referrals, 2) ensure all specialty referrals are screened, processed and appointed in accordance with local policies, 3) receive incoming calls and walk-in visits from patients, and 4) enrollment processing. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-05). GS-7 Grade Level: Specialized Experience: One year of specialized experience which includes 1) answer routine questions from beneficiaries related to medical insurance claims, such as submission, collections, and case resolution processes, 2) assist with counseling beneficiaries on a broad range of healthcare related benefits, and 3) utilize automated healthcare database to enter and retrieve patient data. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06). GS-8 Grade Level: Specialized Experience: One year of specialized experience which includes 1) assist beneficiaries by resolving or correcting discrepancies of existing medical claims, 2) provide regulatory healthcare guidance to the patient population on their rights, benefits, privileges, access to care and available eligibilities, 3) counsel beneficiaries on a broad range of available health benefit programs, and 4) utilize an automated healthcare database to enter and retrieve patient data. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-07). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-07).
About the Position: Location is within Naval Health Clinic Charleston, Goose Creek, ground level. Incumbent will have private office and storage room for education supplies. Work hours are M-F 0730-1600. Applicant will be directly responsible for assisting patients with TRICARE billing and benefits.
Provide beneficiary counseling and assistance to ensure health benefit information is available to eligible beneficiaries.
Act as liaison to assist beneficiaries regarding the TRICARE program, coordinating with medical staff, Tricare Area office service centers, Managed Care Support Contractors, claims processor, and other concerned parties.
Coordinate briefings for the servicing community to include active duty, family members, newcomers, pre-deployment and post deployment.
Utilize various healthcare software applications to verify patient eligibility and complete patient enrollment.
Develop recommendations to change or modify existing procedures or policies that will subsequently provide more effective and improved health care to the beneficiary category populations.
Provide information to resolve problems involving access, payment of bills, and eligibility issues concerning medical care under the TRICARE program.