Medical Reimbursement Technician

Summary

This position is aligned under the Veterans Health Administration Office of Finance, and is physically located in Orlando, Florida at the LAKEMONT ANNEX, Florida-Caribbean Consolidated Patient Account Center(CPAC), in either the Billing or Insurance Verification departments. The Medical Reimbursement Technician is responsible for performing a broad range of duties for medical billings and reimbursable and non-reimbursable collections within the Business Office.

Duties

• ***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher level work, and availability of funds. Major duties and responsibilities include: Verifying veterans' insurance coverage for inpatient and outpatient services, entering updated information, and maintaining the database. Documenting pre-admission requirements and identifying patients requiring second opinions. Responsible for all reimbursable billing activities including consideration of professional services and facility services, sharing agreements, Tricare, Champ VA, Medicare, and pharmacy billing. Validating claims for billing purposes ensuring eligibility and referring questionable coding for review; monitoring reports to assure all possible billable cases are processed; and ensuring proper sequencing of diagnostic and procedural codes and assigns modifiers as needed. Responsible for third party collection from insurance companies and for accounts receivable including humanitarian, DoD, Tricare tort feasor, workman's compensation, fugitive felon, ineligible Champ VA, and no-fault auto accidents. Researching and resolving problems and posting payments, adjustments, denial codes, and non-payment collections. Following up on accounts receivable; determining the accuracy of reimbursement received; responding to correspondence and inquiries; expediting and maximizing collections; maintaining records; and making debt adjustment and assigning funds received to the correct account. Verifying the accuracy of payments, resolving problems and discrepancies, and closing out accounts. Responding to questions and inquiries from veterans and insurance companies. Auditing accounts, ensuring payments recovered by insurance carrier are posted in a timely manner to the veterans Category C bills. Performs other duties as assigned. Work Schedule: Monday-Friday 8:00am-4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not approved

Qualifications

You may qualify at the GS-5 level if you fulfill one of the following qualifications: -GS-5 SPECIALIZED EXPERIENCE: One (1) year of specialized experience that equipped you 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 work of this position? To be creditable, this experience must have been equivalent to at least the GS-4 grade level in the Federal service. Specialized experience includes: following instructions about timeliness, objectives and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; and reviewing and determining the appropriateness of administrative data. -OR- -GS-5 EDUCATION: Successful completion of 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. (TRANSCRIPTS REQUIRED) -OR- -GS-5 COMBINATION: Equivalent combinations of education and specialized experience (as described above) to meet the requirements at the GS-5 level. Only education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement. (TRANSCRIPTS REQUIRED) You may qualify at the GS-6 level if you fulfill the following qualifications: -GS-6 SPECIALIZED EXPERIENCE: One (1) year of specialized experience that equipped you 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 work of this 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: following instructions about timeliness, objectives and relative priorities for doing administrative work; communicating with other staff as necessary to discuss administrative concerns; reviewing and determining the appropriateness of administrative data; validating claims for billing purposes ensuring eligibility and referring questionable coding for review; and interpreting insurance policies and requirements for billing. Physical Requirements: The work may require some physical effort such as, periods of standing, walking, or bending. There are no special physical demands. 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/.

Requirements

You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) - See "Required Documents" below for details. As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

How to apply

Please read the entire announcement and all the instructions before you begin an application. To apply for this position, you must complete the initial online application, to include the initial online assessment and submission of the required documentation specified in the Required Documents section above. The complete application package must be submitted by 11:59 PM (ET) on the closing date of the announcement to receive consideration. To preview the questionnaire, click https://apply.usastaffing.gov/ViewQuestionnaire/13056519. The application process is as follows: To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents. Answer the questions presented in the application and attach all necessary supporting documentation. Click the Submit Application button prior to 11:59 PM (ET) on the announcement closing date, 09/15/2026. After submitting the online application, you will be notified whether or not you are required to take additional online assessments through the USA Hire Competency Based Assessment system. This message will be delivered to you via email notification. The email may be routed to your "Spam" or "Junk" folder. IMPORTANT: If you are asked to take the USA Hire Competency Based Assessments, you will be presented with a unique URL to access the USA Hire system. Access to USA Hire is granted through your USAJOBS login credentials. Be sure to review all instructions prior to beginning your USA Hire Assessments. Click here for Computer System Requirements. Set aside at least 3 hours to take the USA Hire assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue at a later time, you can re-use the URL sent to you via email and also found in your USAJOBS account under the "Track my application" link for the corresponding application. Your responses to the USA Hire Assessments will be reused for one year (in most cases) from the date you complete an assessment. If future applications you submit require completion of the same assessments, your responses will be automatically reused. Visit the USA Hire Applicant Resource Center for practice assessments and assessment preparation resources at https://support-usahire.opm.gov/hc/en-us. To view the announcement status or your application status: https://help.usajobs.gov/how-to. Your application status page is where you can view your application status, USA Hire assessment completion status, and review your notifications sent by the hiring agency regarding your application. Beginning September 27, 2025, Federal agencies will only accept resumes up to two pages in length to comply with the Merit Hiring Plan. Resumes longer than two pages will result in ineligibility for further consideration for the position. USAJOBS will not allow you to upload or build resumes longer than two pages, and you will need to update the resumes in your profile before applying for a job. Resumes should include information relevant to the knowledge, skills, abilities, and competencies of the position to which you are applying. VA is unable to make assumptions about qualifications if not clearly listed. Resumes must be legible so they can be reviewed for eligibility, minimum qualifications and other position requirements listed in the job announcement. Your resume must be 5MB or less. We recommend saving and uploading your resume as a PDF to maintain formatting and number of pages. We also accept GIF, JPG, JPEG, PNG, RTF, TXT, PDF, ODT or Word (DOC or DOCX). We do not accept PDF portfolio files. We recommend using a sans-serif font size like Lato, if available. Other widely available options are Calibri, Helvetica, Arial, Verdana, Open San Source Sans Pro, Roboto or Noro Sans. Make your page margins 0.5 inches. Consider using 14-point size font for titles and 10-point for the main text in your resume. The resume builder can help you create a resume using these recommendations and uses the information in your USAJOBS profile to help you get started. Helpful Hints for Creating a Two-Page Resume: Prioritize most relevant and recent experience Use concise, results focused language Align language from the job announcement Focus on demonstrating skills and competencies Remove outdated or unrelated experience Use the USAJOBS resume builder Additional guidance on this new requirement and resume building tools can be found at: https://help.usajobs.gov/faq/application/documents/resume/page-limit.