The incumbent serves as a Health Benefits Advisor in the Eligibility and Enrollment Section at the CTVHCS. Incumbent is primarily responsible for the intake and administrative processes for Veterans and beneficiaries applying for medical services to our Health Care System or to any of its Community Based Outpatient Clinics (CBOCs), Attention to detail is mandatory for the duties involved in this position.
Summary
The incumbent serves as a Health Benefits Advisor in the Eligibility and Enrollment Section at the CTVHCS. Incumbent is primarily responsible for the intake and administrative processes for Veterans and beneficiaries applying for medical services to our Health Care System or to any of its Community Based Outpatient Clinics (CBOCs), Attention to detail is mandatory for the duties involved in this position.
This vacancy announcement is open to current, permanent Facility (CTVHCS), VA-Wide and CTAP eligible applicants, Only. If you are not a current Department of Veterans Affairs Employee, please apply to: CAZM-11577914-22-JSC.
The incumbent interviews and registers applicants to determine eligibility and legal entitlement of applicants for health care, including assignment into the appropriate enrolment priority group. Applications nay be received in person, by telephone, by mail, by internet, or by referral from another VA. Verifies eligibility using various methods, including income assessments, military discharge documents, Hospital Inquiry (HINQ), Benefits Delivery Network (BDN), Veteran Information Solutions (VIS) and other means such as communication with VA Regional/Office Administers income assessments (means tests). Advises and counsels Veterans and their beneficiaries or representatives of financial obligations, co-pay requirements, and their rights to appeal with and resolves complex eligibility, co-pay, and insurance questions that arise.
Deals with and resolves complex eligibility, co-pay, and insurance questions that arise. Displays adaptability in dealing with a wide range of individuals as necessary. Explains to each individual the specific conditions or actions that could affect their co-pay status or eligibility for benefits. informs Veterans of their responsibility to report changes. Incumbent is responsible for gathering, entering and updating demographic, employment, insurance, and income information into Veterans Integrated Software Technology Architecture (VistA), Enrollment System Redesign (ESR), and other related programs. Incumbent captures specific types of eligibility, such as OEF/OF/OND, Combat Veteran, etc. Information may be gathered by mail, fax, email, and/or in-person. Incumbent schedules series of initial appointments, following each facility's or CBOC's process for when first seeing new patients.
This also requires answering phones that are on an Automated Call Distribution (ACD), system. Incumbent may be assigned, to process electronic applications and/or determine eligibility and schedule appointments for Veterans on the New Enrollee Appointment Request (NEAR) report. When appropriate, the incumbent uses the Electronic Wait List (EWL) and takes necessary actions to schedule Veterans appropriately and as soon as access is available.
The incumbent deals with a variety of benefits and/or obligations (i.e., medical benefits, copay requirements, medication benefits, dental benefits, special transportation and travel benefits) and special registries (i.e.. Agent Orange, psychosis and other mental illnesses, etc.). Reviews particular circumstances of each individual (i.e., military history, marital status, financial situation, medical conditions, etc.) to apply the regulatory requirements that wilt best meet his/her needs.
Processes claims for hardships, catastrophic disability, beneficiary travel deductible waivers, and visit/medication copay waivers. This includes researching for information and informing persons of alternative options. Receives commitments from physicians to admit Veterans into an inpatient status. This includes processing the requests for local county court systems.
Incumbent is responsible for processing requests for Veterans Health Identification Cards (VHIC) upon request. This includes taking photographs of Veterans using the VistA VHIC program and submitting to a contractor to complete and send card to Veterans, Incumbent also receives completed VHIC from the Health Eligibility Center (HEC) that are returned for bad addresses with the expectation the cards will be mailed to the Veteran or destroyed by the facility.
Acts as a resource regarding eligibility issues for Health Care System staff, Veteran Service Organization representatives, and other requesting organizations. Routinely conducts outreach events at different locations to assist in capturing Veterans transitioning from active-duty military.
On an ongoing basis, discusses the most frequent problems involving the contacts with, and the processing of, Veterans, and makes recommendations for- possible solutions to the supervisor, advising him/her of the advantages and disadvantages of proposed operating policy changes involving the section. The incumbent must be able to effectively communicate with a variety of individuals including physicians, nurses, technical support staff, Veterans, and Veterans* families.
Routinely provides administrative processing in emergency situations such as patients being, directly admitted to the Emergency Room with immediate needs.
Performs other related duties as assigned.
Work Schedule: Monday - Friday 7:30 a.m. - 4:00 p.m. OR 8:00 a.m. - 4:30 p.m. Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Assistant/PD08052A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required
Selective Service Registration is required for males born after 12/31/1959
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
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
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/11/2022.
You may qualify based on your experience and/or education as described below:
Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 level in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include but are not limited to: Thorough knowledge of computer systems and options, such as performing various scheduling functions, locating and updating pertinent patient information, appeal rights, and ordering patient records. Ability to understand the use and application of all assigned computer options. Comprehensive working knowledge of VA regulations, public laws, directives, policies and procedures affecting VA programs and operations such as inpatient and outpatient services, admissions, scheduling, sharing agreements, beneficiary travel, prosthetics, pharmacy, dental, and CBOC's. Knowledge and thorough understanding of Business Office programs and how they interrelate to other Health Care System services and programs. OR,
Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have completed four years above high school. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. OR,
Combination: Applicants may also combine education and experience to qualify at this level, only education more than the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement. One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience.
You will be rated on the following Competencies for this position:
Technical Competence
Technology Application
Communication
Customer Service
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; religions; 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.
Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
Physical Requirements: The work is generally sedentary in nature with no special physical demands. Some walking, standing, bending and carrying are occasionally required due to the need to hand deliver and pick up documents between services.
A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Note: If your school has changed names, or is no longer in existence, you must provide this information in your application.
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.
Additional information
Receiving Service Credit or Earning Annual (Vacation) Leave: 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.
The Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.
This job opportunity announcement may be used to fill additional vacancies.
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 selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process.
To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce the COVID-19 vaccination requirement pursuant to Executive Order 14043 on Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a VA job announcement includes language requiring applicants to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply to this Job Announcement. VA may request information regarding your vaccination status, if selected, for the purposes of implementing other workplace safety protocols, such as masking, physical distancing, testing, travel, and quarantine.
If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
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.
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.
How you will be evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.
Narrative responses are not required at this time. If you are referred for consideration, you may be asked to submit additional job related information, which may include, but not limited to; responses to the knowledge, skills and abilities; completion of a work sample, and/or contact for an interview. Your resume and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.
Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
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.
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.
To apply for this position, you must provide a complete Application Package which includes:
Resume
SF-50/ Notification of Personnel Action
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
Cover Letter
DD-214/ Statement of Service
Diploma/ GED
Disability Letter (Schedule A)
Disability Letter (VA)
License
OF-306
Other Application Documentation
VA Application 10-2850, a, b, c, or d (Current within 90 days)
Other (3)
Other (4)
Other (5)
PCS Orders
Performance Appraisal
Professional Certification
Proof of Enrollment
Proof of Marriage Status
Resume
Separation Notice (RIF)
SF-15
SF-50/ Notification of Personnel Action
Transcript
SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
Most recent SF-50 if you are a current or former Federal employee
An SF-50 showing your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade
Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
Examples of appropriate SF-50's include:
Within grade increases at the highest grade held; or
Promotions with an effective date more than one year old; or
SF-50's at the highest grade held with an effective date more than one year old.
Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
All applicants are encouraged to apply online. To apply for this position, you must complete the questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 08/11/2022 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/11577912.
To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
Click Submit My Answers to submit your application package.
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.
VA Central Texas Health Care System
1901 Veterans Memorial Drive
Temple, TX 76504
US
Next steps
Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
To apply for this position, you must provide a complete Application Package which includes:
Resume
SF-50/ Notification of Personnel Action
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
Cover Letter
DD-214/ Statement of Service
Diploma/ GED
Disability Letter (Schedule A)
Disability Letter (VA)
License
OF-306
Other Application Documentation
VA Application 10-2850, a, b, c, or d (Current within 90 days)
Other (3)
Other (4)
Other (5)
PCS Orders
Performance Appraisal
Professional Certification
Proof of Enrollment
Proof of Marriage Status
Resume
Separation Notice (RIF)
SF-15
SF-50/ Notification of Personnel Action
Transcript
SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
Most recent SF-50 if you are a current or former Federal employee
An SF-50 showing your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade
Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
Examples of appropriate SF-50's include:
Within grade increases at the highest grade held; or
Promotions with an effective date more than one year old; or
SF-50's at the highest grade held with an effective date more than one year old.
Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
All applicants are encouraged to apply online. To apply for this position, you must complete the questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 08/11/2022 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/11577912.
To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
Click Submit My Answers to submit your application package.
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.
VA Central Texas Health Care System
1901 Veterans Memorial Drive
Temple, TX 76504
US
Next steps
Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
