Health Insurance Specialist

Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Financial Management, Payment Accuracy and Reporting Group (PARG). As a Health Insurance Specialist, GS-0107-13, you will serve as the primary CMS focal point for functional administration and oversight of the Comprehensive Error Rate Testing (CERT) Program, and for internal and external reporting of CMS's Medicare FFS improper payment activities.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume (limited to no more than 2 pages) must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from being considered further. In order to qualify for the GS-13, you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-12 grade level in the Federal government, obtained in either the private or public sector, to include: Providing support to improper payment measurement contractors on Medicare Fee-for-Service (FFS) policies and requirements; AND, Communicating to the public or medical professionals on the coverage policies related to the items and services that are eligible for payment under Medicare FFS rules; AND, Educating providers, beneficiaries, and stakeholders on compliance, billing, reporting, or other operational aspects of the Medicare FFS program; AND, Preparing briefing materials or reports, such as contributing to the Payment Integrity Report section of the annual Agency Financial Report (AFR) and compiling supplemental improper payment data for program oversight and transparency. 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). Volunteer work helps build critical competencies, knowledge, and skills, and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Time-in-Grade: To be eligible, current or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13094438