Summary This position is located in the Pharmacy Department at the Phoenix Indian Medical Center, in Phoenix, AZ. The incumbent serves as a Billing Technician and Pharmacy Technician performing a combination of duties in both areas of billing and pharmacy. The primary purpose of this position is to abstract and interpret data from pharmacy records in preparation and submission of pharmacy point of sale billing claims. The incumbent will report to the Supervisory (POS) Pharmacy Technician onsite. Responsibilities **This position is being announced concurrently under Delegated Examining Plan (DE) procedures. Please review vacancy announcement number IHS-24-PX-12386729-DE; for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered.** Receives the pharmacy prescription dispensing reports electronically via online billing system. Ensures that prescription dispensed are entered into the system with the correct brand name or generic name, for this information is the key to the charge generated per visit and maintained in the accounting records. Researches patient records, reconstructs incorrect or missing medical information required to prepare a valid insurance billing when data received is incomplete. Analyzes, maintains, and directs the total billing operation for pharmacy point-of-sale programs, and acts as an advocate for Indian Health Service in the collection of Alternate Resources. Request and obtains prior authorization for various pharmaceutical products from insurance companies. Researches and follows up on rejected claims online in order to ensure maximum reimbursement to the facility. Develops and maintains files for the tracking of billing and reimbursement. Responds to third party requirements on post-payment reviews, exclusions, denials, and appeals. Requirements Conditions of Employment Must pass pre-employment examination. Selectee may be subject to a probationary/trial period ESEP appointees typically serve a two year trial period U.S. Citizenship is required Selective Service Registration is required for males born after 12/31/1959 This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Confidential Financial Disclosure Form required. Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities. Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/. A bank account at a financial institution is required for electronic direct deposit of salary payment. Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process. Qualifications 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, GS-0661: Specialized Experience: For positions at GS-4 and above: Qualifying specialized experience may have been gained in hospital pharmacies, retail pharmacies, or in pharmaceutical firms or laboratories. Experience must have provided a basic knowledge of: Pharmaceutical nomenclature Characteristics, strengths, and dosage forms of pharmaceuticals Pharmaceutical systems of weights and measures; and the Variety of procedures and techniques involved in the care, storage, repackaging, bulk compounding, and distribution of pharmaceuticals. In addition to the Individual Occupational Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS, GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples Include: filling prescriptions utilizing automated dispensing equipment; distributing pharmaceuticals; utilizing pharmacy based computer systems; working with insurance claims to bill for pharmaceuticals and resolve any billing issues; and performing pharmaceutical procurement and inventory management. MINIMUM QUALIFICATIONS, GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Evaluating, analyzing and coordinating work activities to meet workflow demands; independently gathering and analyzing data to generate reports for statistical purposes; training new employees and other pharmacy staff; operating and maintaining specialized pharmacy equipment; performing pharmaceutical procurement and formulary management; maintaining controlled substances per policy and procedure; resolving third party billing discrepancies, including comprehensive management of pharmacy point of sale functions. OR Education: You must have successfully completed 1 full year (18 semester hours) of graduate education that is directly related to the work of the position (Transcripts Required) OR Combination of Education and Experience: Have a combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-07 grade level (Transcripts Required). NOTE: Graduate education or an internship meets the specialized experience required above GS-5 only in those instances where it is directly related to the work of the position. One full year of graduate education meets the requirements for GS-7. One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent 1 year of full-time study. If that information cannot be obtained from the school, 18 semester hours should be considered as satisfying the 1 year of full-time study requirement. Part-time graduate education is creditable in accordance with its relationship to a year of full-time study at the school attended. 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. Education This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer. Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.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/. Additional Information Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. This position has the potential for remote work in accordance with IHS Telework Flexibilities Policy and Supervisory Approval prior to a job offer. Remote Work. A workplace flexibility allowing an employee to work at an approved alternative worksite, within or outside the local commuting area of the agency worksite, with no expectation to report to the agency worksite on a regular and recurring basis. Remote - Within the Local Commuting Area. A position designation used when there is some frequency for an onsite presence (e.g., expectation for in-person collaboration or other in-person work activities on an irregular basis, or duties require an irregular, but consistent, e.g.,twice per month, presence at the agency worksite). For these positions, employees should have an official worksite/alternative worksite1 within the local commuting area. Remote - Outside the Local Commuting Area. A position designation used when there is little to no onsite presence (e.g., expectation is for in-person requirement once or twice annually). This position is covered by a Bargaining Unit. This position has promotion potential to the GS-07 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.