Remote Entry Level Medical Billing Jobs in Kansas

Summary
The incumbent will work within the Clinical Pharmacy Resource Section of Pharmacy Service under the Supervision of a Supervisory Pharmacist performing assignments in the specialized area of pharmacy copayments. He/she will gather, evaluate, analyze data, and apply management and leadership principles in researching the accuracy of Veteran medication copayments.
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Duties
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Major duties include, but are not limited to the following;

• Makes independent clinical determinations of medication charges relating to disease state treatment for both Service Connected and Special Authority presumptive conditions.
• Gathers treatment information from the clinical patient record, evaluates therapeutic drug treatments for clinical conditions, and analyzes their relationship to accurate prescription billing practices.
• Corrects billing for prescription drug copayments based upon expert clinical determinations matching patient diagnosis and approved drug therapy.
• Identifies clinical parameters for thorough billing reviews to include additional eligibilities that may have been identified when the case was received.
• Calculates dosages based upon provider instructions to ensure quantities of medications prescribed are sufficient for the length of treatment being billed.
• Exhibits extensive working knowledge of the Clinical Pharmacy Resource operations and applies specialized pharmaceutical knowledge in conjunction with utilization of VA information systems (such as VistA, CPRS, VIS, VBMS, VES, and Capri) to evaluate prescription billing appropriateness for Veterans and family members.
• Works cooperatively and in conjunction with Pharmacy Service Supervisory Pharmacists on performance improvement activities, patient safety issues, and effective communication recommendations between VA Medical Center, Revenue Utilization Review, Veterans and their families.
• Evaluates and implements rules, laws, regulations, and policies to ensure accuracy of medication dispensing processes and determine course of action specific to the situation.
• Provides Veteran medication co-payment validations on a national scope and resolves medication copayment questions from Veterans, VISNs and all VA facilities upon request.
• Provides guidance and assistance to Third Party Administrators requesting Prior Authorization for continuation of medication therapy.
• Utilizes advanced communication technologies such as MyHealtheVet to communicate results of prescription billing reviews to Veterans.

Pharmacy Technician: vacareers.va.gov/wp-content/uploads/sites/5/Total-Rewards-of-a-Pharmacy-Technician-Career-Flyer.pdf
Work Schedule: Tour of Duty: Monday - Friday between the hours of 7:00 am - 5:30 pm (40 hours per week)
Telework: Telework is not authorized for this vacancy.
Virtual: This is not a virtual position.
Remote: This is not a remote position
Functional Statement #: 32201-A
Recruitment Incentive (Sign-on Bonus): Not Authorized
Permanent Change of Station (PCS): Not Authorized
Requirements
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Conditions of employment

• You must be a U.S. Citizen to apply for this job.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• You may be required to serve a probationary period.
• 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 dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment physical evaluation (if applicable).
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

Qualifications
********* Please be advised that both the USA Hire and the Minimum qualification assessments MUST be completed and submitted in order for applicants to be considered for this position. **********
NOTE: Due to a critical staffing shortage, 38 U.S.C.7412 waives the requirement to apply Veterans' preference to ALL external applicants for this job announcement.
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.
Basic Requirements:
United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
English Language Proficiency: Pharmacy Technician candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f).
Certification: For positions above the full performance level, the employee must pass a national certification exam and hold an active national certification through either:

1. Pharmacy Technician Certification Board (PTCB), Certified Pharmacy Technician (CPhT) OR
2. National Healthcareer Association (NHA), Certified Pharmacy Technician (ExCPT)

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).
GS-08 Pharmacy Technician Grade Determination: In addition to meeting the Basic Requirements listed above, you must meet the following:
Experience: Candidates must possess one year of experience equivalent to the next lower grade level (GS-07) and demonstrate the KSAs below.
*** NOTE: Individuals selected for interviews must be prepared to provide written responses to the KSAs below ***
Demonstrated Knowledge, Skills and Abilities (KSA): In addition to the experience above, the candidate must demonstrate the following KSAs:

1. Comprehensive knowledge of concepts, principles, methodology and policies in a specialized area or section of pharmacy (such as sterile compounding, controlled substances, automation, clinical pharmacy, contact center, etc.) Note: See Specialized Area.in the Definitions Section of this qualifications standard.
2. Skill in training and orienting new and existing pharmacy facility employees and students on proper policies and procedures.
3. Ability to evaluate, analyze and coordinate workflow and work activities within a specialized area or section of the pharmacy.

Assignments: For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity and range of variety and be performed by the incumbent at least 25% of the time. Pharmacy technicians at this level have a higher level of responsibility for specialized areas of pharmacy and are expected to independently carry out assigned tasks of considerable difficulty. Pharmacy technicians at this grade level may be appointed to one of the following assignments:

• Pharmacy Technician. Pharmacy technicians in this assignment specialize in areas such as sterile compounding, oncology, controlled substances, medication history review, clinical specialist(anticoagulation, pain, infectious diseases), clinical informatics, automation, immunizations and any other specialized area in the advancement of the profession. The pharmacy technician will serve as a subject matter expert and key resource in the day-to-day technician duties of the specialized area. The technician will be performing assignments such as compounding sterile products, filling controlled substance prescriptions while maintaining compliance with Drug Enforcement Agency (DEA) regulations, taking medication histories and counseling patients, managing automation, managing workflow and training and orienting staff in the specialized area.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: Light lifting (under 15 lbs.); light carrying (under 15 lbs.); reaching above shoulder; use of fingers; both hands required; walking (2 hours); standing (2 hours); ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13" to 16" to Jaeger 1 to 4; far vision correctable in one eye to 20/20 and to 20/40 in the other; depth perception; ability to distinguish basic colors; ability to distinguish shades of colors; hearing without aid. Work may be performed dry atmospheric conditions; constant noise; working closely with others.
Education
Education may not be substituted for experience at this grade level.
Additional information
During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.This job opportunity announcement may be used to fill additional vacancies.This position is in the Excepted Service and does not confer competitive status.
Veterans' preference does not apply for internal or other current permanent Federal agency employees.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations.
If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Benefits
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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.