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ACCOUNTING TECHNICIAN
G S -525-05
I. INTRODUCTION:
This position is located in the Fort Defiance Service Unit, Division
of Administration and Management, Business Office Service Branch,
Finance Section. The primary purpose of this position is to perform
a major segment of technical budgetary and accounts receivable support
functions to the Budget/Accounting and Patient Accounts sections.
II. MAJOR DUTIES AND RESPONSIBILITIES:
Maintains identified corrective action received from Fiscal Intermediaries
or third party payers to be shared of communicated with the Utilization
Review Coordinator for review of diagnosis, length of stay, or coding
transaction for possible reconsideration and appeal for payment.
Maintains current documentation and guidelines pertaining to reimbursement
and Utilization Review activities in appropriate files, binders,
etc., and ensures preparation and distribution of copies to all
appropriate disciplines.
Maintains the accounts receivable ledger and associated records
and documentation in the I H S accounting system. Receives, reviews
and reconciles for correct data and processes collection schedules;
liquidates necessary accounts receivables. Computes and prepares
adjustments in the local automated accounts receivable programs.
Incumbent safeguards the contents of the Alternate Resources program
health insurance claims and Medical Records as a privileged communication
with disclosure of information only within the limits of I H S policy.
Completes special projects within required time frame to ensure
compatibility of project specifications.
Performs routine recurring budget duties which facilitate the conduct
of more complex and detailed review and analysis by the Finance
Officer and Business Office Manager. Work performed by the incumbent
supports the budget expenditures transactions for the Fort Defiance
Service Unit, through appropriated and collected funds.
Gathers extracts, reviews, verifies and consolidates a variety
of reimbursement information and statistical data needed in the
formulation and presentation of fiscal data.
Prepares monthly, quarterly and annual reconciliation and recapitulation
of third party billing to assure that collections, billed data,
and the computerized and manual reports are in balance.
Supervise the filing of all pending and completed health insurance
claims and correspondence relative to the third party and primary
care provider programs.
Maintains Medicare/Medicaid and Private Insurance manuals, and
directives; Provider Reimbursement Manual; Direct dealing Provider
Letters; Federal Health Insurance for the Aged; Transmittal of Bills;
Vouchers and Schedules and any addendum to the I C D-9-C M coding
Volumes.
III. FACTORS:
Factor 1 - KNOWLEDGE REQUIRED BY THE POSITION: Level 1-3 350 points
Knowledge and understanding of established and standardized bookkeeping
and accounting procedures and techniques sufficient to handle
duties such as classifying accounting records in an accounting system.
Classifying a group of related transactions which regularly affects
a small number of control accounts, that is, 6 to 10, and a number
of subsidiary accounts which must be properly identified and which
include recurring types of adjustments for which procedures are
well established.
Knowledge of a variety of accounting transactions and documents,
accounting symbolic codes, account structures, and procedures for
setting up and crediting accounts receivables.
Knowledge of total program, operation, the priorities and goals
of the Alternate Resources program. Keeps abreast of current changes
in policies regulations on eligibility, medical terminology, anatomy
and physiology, diagnostic and financial coding. Participates in
planning, implementation, and improvements of the Alternate Resources
program.
Working knowledge of I C D-9-C M coding procedures, abbreviations
and terms used in the I C D-9-C M coding volumes and A M A C P T-4
coding system in order to acquire, interpret and resolve problems
based on information derived from system monitoring reports to carried
over the U B-82 and/or H C F A 1550 forms.
Knowledge of established procedures, required forms, etcetera,
associated with various health insurance programs.
Knowledge of, and the ability to apply the Alternate Resources
regulations; P. L. 94-437, Title IV of Indian Health Care improvement
Act, I H S Policy and Regulations on Alternate Resources, C F R
42-36.21 (A) and 23 (F), and P. L. 99-272, Federal Medical Care
Cost Recovery Act.
Factor 2 - SUPERVISORY CONTROLS: Level 2-3 350 points
The incumbent works under the general supervision of the Finance
Officer who establishes general guidance and advice, and suggests
techniques for handling unusual or nonrecurring situations which
have no clear precedents.
Incumbent independently plans and carries out the successive steps
and handles problems and minor deviations in the work assignments
in accordance with instructions, policies, etcetera.
Factor 3 - GUIDELINES: Level 3-3 275 points
A number of substantive guidelines are utilized by the incumbent.
The incumbent uses judgement in locating and selecting the most
appropriate guidelines, references and procedures for application
and in making minor deviations to adapt the guidelines to specific
cases.
Factor 4. - COMPLEXITY: Level 4-3 150 points
The incumbent determines how each budgetary and accounting transaction
should be processed in accordance with available guidelines and
instructions, and adjusts accounts to reflect net gains and losses.
The incumbent decides at each stage of the transaction whether proper
procedures are being followed.
There are a wide variety of appropriated and reimbursable fund
transactions, which require the incumbent to identify and adjust
into related accounting codes.
Patient Account support consists of duties that involves different
and unrelated processes and methods. The complexity of the work
involves working with various programs which cover different states,
with each health insurance program having different benefits,
deductible, and eligibility requirements. The work involves working with various
outside agencies in regard to third party resources, that is,
Insurance Companies, Medicare and Medicaid eligibility workers and other
health care professions. Analyses and evaluates accounts of bill
submitted for payment. Provides recommendations for improving collections
on all outstanding bill, utilizing the automated accounts receivable
program. Provides statistical analysis of all outstanding bills,
closed accounts, and accounts unresolved. Reimbursement statistical
reports will be submitted on a monthly basis. These reports will
be reconciled with Navajo Area Finance Collection Reports.
Factor 5 - SCOPE AND EFFECT: Level 5-2 75 points
The incumbent assists in maintaining the balances, and reconciles
the funds collected which are used by the Service Unit and Area
Office programs for projects, and planning purposes, which aids
the overall objective to elevate the health status of Indian beneficiaries.
The successful efforts of the incumbent directly affects the funds
collected.
Factor 6 - PERSONAL CONTACTS: Level 6-2 25 points
The incumbent has regular and recurring contacts employees in the
same agency, state and local agencies, health insurance carriers,
Fiscal Intermediaries, etc.
Factor 7 - PURPOSE OF CONTACTS: Level 7-2 50 points
The purpose of these contacts are to plan and coordinate the work
of the office, resolving problems regarding billing claims and following
up to ensure that required actions are completed and resolving differences
in costs of initial reimbursements presented for health care services
provided.
Factor 8 - PHYSICAL DEMANDS: Level 8-1 5 points
The work is primarily sedentary with some carrying of computer
reports and ledgers. Occasional walking is required since interaction
between all disciplines within the facility is required.
Factor 9 - WORK ENVIRONMENT: Level 9-1 5 points
The work is usually performed in an office setting.
OTHER FACTORS:
The Privacy Act of 1974 mandates that the incumbent shall maintain
complete confidentiality of all administrative, medical, and personnel
records, and all other pertinent information that come to his/her
attention or knowledge. The Privacy Act carries both civil and criminal
penalties for unlawful disclosure of records. Violations of such
confidentiality shall be cause for adverse action.
{s t d} Employees in this series classify accounting transactions,
maintain and reconcile accounts; close accounts and prepare reports
and statements; analyze accounting data; and examine accounts. Accounting
technicians classify accounting transactions that include verifying
the accuracy and completeness of the accounting data; determining
the general ledger accounts, journals, and subsidiary accounts affected
and the debit and credit entries to be made. They also summarize
transactions and prepare control documents or other posting documents
reflecting the entries to be made. Accounting technicians maintain
accounts by reviewing documents to verify accounting data as necessary,
entering data into the system, and taking a trial balance. They
reconcile accounts comparing account balances with related data
to assure agreement; reviewing records and source documents to identify
the sources of discrepancies; and determining the entries required
to bring the account into balance. They close accounts and prepare
balance sheets and financial statements. They also abstract data
reflecting financial condition and operating results; and present
this data in the form of statements and reports. Accounting technicians
examine accounts to verify the accuracy of accounts and adequacy
of supporting data. They also prepare worksheets or reports reflecting
the examinations made, discrepancies noted, and the corrective entries
required to adjust accounts. Some accounting technicians review
the efficiency of clerical processes and compliance with prescribed
procedures, and recommend improvements such as the need for coordination,
additional training, or clarification of procedures to reduce errors
or processing delays.
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