Contact Representative (Benefits)

There MAY NOT be immediate vacancies at all locations. Verifies and determines patient's eligibility for Medicare, Medicaid, Private Insurance, VA or other potential alternate resources. Provides information on rights and benefits of multiple alternate resources and advises patient of nonpayment or denial of claims.

Identifies and follows up on pending applications and timely entry of all third party resources. Conducts face-to-face interviews or by telephone with patients and/or families to ensure accurate and complete enrollment application. Obtains copies of verification of household income or other source of documentation, requests all other income from beneficiary and household members.

Initiates medical authorizations and denial of service for inpatient/outpatient/ancillary medical services for eligible IHS beneficiaries. Investigates and analyzes controversial issues. Issues correspondence to patients, health care providers and other agencies regarding eligibility, IHS policy and regulations, including letters of denial of payment where the requirements of the IHS Program are not met.

Tracks all referrals to non-IHS facilities to include those referrals to other IHS facilities to support the Case Management activities and continuity of care efforts. Participates in the weekly Case Management meetings, takes minutes and prepares the minutes for record and reporting purpose.

Selectee may be subject to a probationary 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 IHS Selectees that will work in an IHS health care facility may be subject to Employee Health Policies related to Measles and Rubella, and seasonal influenza immunizations. Vaccine exemption requests may be available according to the National and/or Service Unit guidance.

On-call hours or standby duty may be required. 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/.

You will need to set up direct deposit so we can pay you. Background Investigation Requirement: This position requires the successful completion of a federal background investigation as a condition of employment. A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.

Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability. Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.

There are no education requirements.

This is an Open Continuous Announcement. There MAY NOT be immediate vacancies at all locations.

You will be limited to selecting no more than 5 locations during the application process and will only be considered for the locations you select. Eligible applicants will be referred out as vacancies occur.

You will be evaluated for this job based on how well you meet the qualifications above. Once the application process is complete, the first two pages of your resume and supporting documentation will be used to determine whether you meet the job qualifications. Structured Resume Review: Subject matter experts (SMEs) will review your resume to determine your technical qualifications for this position based on the required competencies.

SMEs will review ONLY the first two (2) pages of your resume. SMEs will not review additional information beyond your resume (e.g., cover letter, links embedded in your resume). Once the announcement closes, we will conduct a review of your application package to verify your eligibility and qualifications.

If you are found qualified, your application will move forward to additional phases of the review process. To ensure a fair and consistent hiring process, IHS uses a multi-hurdle assessment process. Each "hurdle" must be passed before moving to the next step.

This helps us evaluate applicants based on job-related qualifications, competencies, and experience. Below is what applicants can expect: ________________________________________ 1. Minimum Qualifications Review - Hurdle 1 HR reviews your resume to confirm you meet the eligibility and minimum qualifications for the position (education and/or licensure (if applicable), listed above).

Note: the first two pages of your resume and supporting documentation will be used to determine whether you meet the minimum qualifications. If you meet eligibility and minimum qualifications, you move to the next hurdle.

1. Technical Assessment (Subject Matter Expert Resume Review) - Hurdle 2 A panel of subject matter experts (SME) will review your resume to determine whether you clearly show the required specialized experience listed below.

Note: SMEs will review ONLY the first two (2) pages of your resume. SMEs will not review additional information beyond your resume (e.g., cover letter, links embedded in your resume). This assessment is Pass/Fail.

Applicants who demonstrate the required experience will advance. Knowledge of, and ability to apply a multitude of Alternate Resource regulations, knowledge of medical terminology, ability to act as an advocate for patients, ability to maintain effective work relationships with patients, co-workers, and community, knowledge of Privacy Act and HIPAA, use of confidential information and health records, and maintaining confidential patient information. Demonstration of these specialized experience statements ascertain your competency in the following: Customer Service (Clerical/Technical) Oral Communication Reasoning Technical Competence Click here to view vacancy questions: https://apply.usastaffing.gov/ViewQuestionnaire/12890116.

The first cutoff date will be Friday, February 27, 2026, at 11:59 pm EST. Future cutoff dates will be each Friday thereafter at 11:59 pm EST until the closing date.

Your application will remain active for 90 days from the submission of application.

This is an Open Continuous Announcement. There MAY NOT be immediate vacancies at all locations.

You will be limited to selecting no more than 5 locations during the application process, and will only be considered for the locations you select. Eligible applicants will be referred out as vacancies occur. 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 maybe covered by a Bargaining Unit. Recruitment or relocation incentives may be authorized. A service agreement will be required.

This position has promotion potential to the GS-8 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.

You will be evaluated for this position in accordance with the OPM Merit Hiring Plan. As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions. How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government?

In this role, how would you use your skills and experience to improve government efficiency and effectiveness? How would you help advance the President's Executive Orders and policy priorities in this role? How has a strong work ethic contributed to your professional, academic or personal achievements?

Your responses are optional and will not be scored. However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process.

You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot). Financial Suitability Requirement: This position requires a review of the applicant's financial history as part of the personnel security and suitability determination.

Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying. Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS). The first cutoff date will be Friday, February 27, 2026, at 11:59 pm EST.

Future cutoff dates will be each Friday thereafter at 11:59 pm EST until the closing date.

You must complete the application process and submit all required documents electronically by 11:59 p.m. (Eastern Standard Time) of the cut-off date/day listed.

To apply for this position, you must provide a complete Application Package. See required documents below. To begin, click the Apply Online button on the vacancy announcement.

You will be directed to the Login.Gov screen, here will you sign in if you have an existing USAJOBS account or Create a Login.Gov account. If you have an account you will be directed to select a resume or create a resume. If you create an account you can create an resume.

Click save and continue.

Follow the prompts to upload your resume and/or supporting documents.

Click the Apply To This Vacancy and complete all steps in the application process until the Confirmation indicates your application is complete. If you click Return to USAJOBS or get timed out prior to receiving confirmation, your application will not be submitted and cannot be considered for this job. Read and complete all Eligibility questions. Review the REQUIRED DOCUMENTS section of this announcement to determine which apply to you and must be submitted online.

You may choose one or more of the following options to submit your document(s): Upload (from your computer) or USAJOBS (click the "USAJOBS" link to complete the transfer process). Beginning September 27, 2025, Federal agencies will only accept resumes up to two pages in length to comply with the Merit Hiring Plan. Resumes longer than two pages will result in ineligibility for further consideration for the position. USAJOBS will not allow you to upload or build resumes longer than two pages, and you will need to update the resumes in your profile before applying for a job.

Resumes should include information relevant to the knowledge, skills, abilities, and competencies of the position to which you are applying. IHS is unable to make assumptions about qualifications if not clearly listed. Helpful Hints for Creating a Two-Page Resume: Prioritize most relevant and recent experience Use concise, results focused language Align language from the job announcement Focus on demonstrating skills and competencies Remove outdated or unrelated experience Use the USAJOBS resume builder For additional questions please see our Frequently Asked Questions (FAQs) found here: http://www.ihs.gov/jobs/index.cfm?module=search&option=faq.

The IHS provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application and hiring process, please notify the Human Resources Office. The decision on granting reasonable accommodation will be on a case-by-case basis.

USAJOBS Help Center - Update your resume now so it meets new resume requirements. Resume: You are highly encouraged to visit the USAJOBS Help Center before submitting a resume. USAJOBS Help Center - Update your resume now so it meets new resume requirements Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records.

For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/media_document/1076-0160_indian-pref_expires-04.30.25_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.

Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.

Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf. Current or former Federal employee: Include your most recent SF-50 or if Reinstatement eligible include your Career SF-50. Noncompetitive eligibles: Submit additional documents to prove your eligibility to apply to this vacancy.

Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application.

You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer. Licensure, Certifications: Applicants should list their license/certifications on their resume, along with the expiration date, if applicable. Certification of licensure/certification will be required after tentative selection and prior to issuing an official job offer.

You must complete the application process and submit all required documents electronically by 11:59 p.m. (Eastern Standard Time) of the cut-off date/day listed.

Your application will remain active for 90 days from the submission of application.