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Patient Services Assistant

Department of Veterans Affairs
Veterans Health Administration
Veterans Health Administration
This job announcement has closed

Summary

The Patient Services Assistant is in the Enrollment/Means Test Unit Section under the supervision of the Member Services Supervisor. The employee is responsible for verifying and certifying the legal eligibility of applicants seeking medical treatment and/or benefits. The position is located at the VA Medical Center located in Fargo, ND.

Overview

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Reviewing applications
Open & closing dates
11/07/2024 to 11/14/2024
Salary
$39,576 to - $51,446 per year
Pay scale & grade
GS 5
Location
1 vacancy in the following location:
Fargo, ND
1 vacancy
Remote job
No
Telework eligible
No
Travel Required
Not required
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
None
Supervisory status
No
Security clearance
Other
Drug test
No
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
Financial disclosure
No
Bargaining unit status
Yes
Announcement number
CARZ-12598232-25-LJM
Control number
818037000

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Duties

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***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION***

Duties include but may not be limited to:

  • Establishes legal entitlement to determine eligibility of applicants for healthcare benefits.
  • Obtains and reviews insurance policies and plans.
  • Serves as the key contact for veterans seeking guidance with eligibility inquiries, which may be regular and recurring contacts.
  • Conducts interviews with applicants and family representatives to establish medical eligibility.
  • Ensures documentation is obtained, verifying eligible medical and/or dental services can be provided.
  • Interprets and explains issues such as deductibles, co-payments, length of stay and other matters to applicants.
  • Investigates authorizations, orders, and/or utilizes the Computerized Patient Record System (CPRS) to review medical records, forwards for supervisory approval and submits all documents for payment utilizing appropriate control point for reference.
  • Prepares eligibility notification documents regarding health and/or dental care qualifications.
  • Communicates insurance and program information to eligible patients and explains denial of benefits in a diplomatic, professional manner.
  • Prepares and forwards inquiries to the Regional Office for establishing eligibility and/or verifying service information to continue the process of the application.
  • Processes applications received that are determined ineligible for VA Health Care.
  • Manages the means testing and copay exemption test program.
  • Utilizes a variety of office equipment and automated software.
  • Performs other duties as assigned.

Work Schedule: Monday - Friday, 8:00am - 4:30pm
Recruitment & Relocation Incentives: Not authorized
Critical Skills Incentive (CSI): Not approved

Requirements

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Conditions of employment

  • You must be a U.S. Citizen to apply for this job
  • 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, applicant(s) must meet the following qualifications:

English Language Proficiency - In accordance with 38 U.S.C. 7402(d), No person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. You must be proficient in basic written and spoken English in order to meet the requirements of this position.-AND-

SPECIALIZED EXPERIENCE: Requires at least one (1) full year of specialized experience that equipped the applicant with the knowledge, skills and abilities to perform the duties of the Patient Services Assistant position. To be creditable, this experience must have been equivalent to the next lower grade level (GS-04) in Federal Service. Specialized experience is experience with the laws and regulations pertaining to determining eligibility entitlement of applicants for health care and other benefits; obtaining and reviewing insurance policies and plans; interpreting/explaining issues such as deductibles, co-payments, length of stay and other matters; and utilizing a variety of office equipment and software. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding experience.) -OR-

SUBSTITUTION OF EDUCATION FOR EXPERIENCE (TRANSCRIPT REQUIRED): Requires four (4) years of successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. -OR-

COMBINATION OF EDUCATION AND EXPERIENCE (TRANSCRIPT REQUIRED): Equivalent combinations of successfully completed post-high school education and specialized experience to meet total qualification requirements for this position. Only education in excess of 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 as part of the assessment questionnaire for this position:

  • Administrative Law
  • Clerical
  • Communications
  • Computer Skills


IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. 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.

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.

Physical Requirements: The work is mainly sedentary but requires some light walking, standing, bending, and lifting. The position requires constant viewing of a computer screen and hours of keyboarding daily. Infrequent walking to various locations of the Hospital with records of patients is necessary.

For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

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: Recognition of Foreign Qualifications | International Affairs Office (ed.gov).

Additional information

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.

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.

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. If your resume does not support your questionnaire answers, we will not allow credit for your response(s).

Your responses to the assessment questionnaire will be reviewed along with the information provided in your resume and supporting documentation to determine if you are qualified for the position. If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your rating may be lowered and/or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

Candidates who apply under All U.S. Citizens announcements will be rated and ranked using Category Rating procedures. Qualified candidates will be assigned to a quality category. The categories are defined as follows:

  • Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position;
  • Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job;
  • Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
  • Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.
Application of Veterans' Preference: Category rating and selection procedures place those with veteran's preference above non-preference eligibles within each category. Preference eligible applicants that meet the eligibility and qualification requirements and who have a compensable service-connected disability of at least 10 percent are listed in the highest quality category (except when the position being filled is scientific or professional at the GS-09 grade level or higher).

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.

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