Medical Reimbursement Technician

Quick Facts

• Role: Medical Reimbursement Technician
• Location: Office setting in Middleton, Wisconsin (must live within or be willing to relocate within commutable distance)

Description

The Medical Reimbursement Technician validates medical claims, ensuring eligibility and referring questionable coding for review. You will submit claims to third-party health insurance carriers, apply Medicare coverage understanding, and interpret payer policies to support Medicare reimbursable billing and collections. The role uses standardized work control systems and processes billings using diagnosis and procedure codes.

Responsibilities

• Validate claims for billing eligibility; refer questionable coding for review
• Submit claims to third-party health insurance carriers with Medicare coverage knowledge
• Interpret third-party insurance policies and billing requirements
• Perform Medicare reimbursable billing activities
• Follow timeliness and priority instructions; manage competing deadlines
• Adapt to changing demands within set timelines
• Work standardized batches/caseload structures via control systems
• Use office software applications (e.g., Microsoft Access, Excel, Word)
• Compose situational correspondence
• Process billings using ICD-9-MC, CPT/4, and HCPCS codes

Requirements

• U.S. citizen
• Complete required application steps including an online assessment (USA Hire competency based)
• Selective Service registration (if applicable)
• Background/security investigation
• Complete online onboarding and provide acceptable identification (REAL ID compliant required from May 7, 2025)
• Seasonal influenza vaccination program participation (VA requirement)
• 1-year probationary period after acceptance; continuation depends on performance and public interest
• Meet GS-05 or GS-06 qualification standards:
  • GS-05: 1+ year specialized experience in administrative/clerical support tied to office operations, OR 4+ years accredited education above high school, OR an approved combination (transcripts required)
  • GS-06: 1+ year specialized experience related to medical billing and/or insurance verification processes (transcript not substituted)

Benefits

A comprehensive federal benefits package is available; eligibility depends on the position type and may include benefits for you and your family.