Clarification from the agency

ALL US CITIZENS DIRECT HIRE AUTHORITY: This position is being filled using Direct-Hire Authority (5 CFR 337.201) for this occupation.

Videos

VA Healthcare System Serving Ohio, Indiana and Michigan (VISN 10) advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

Major Duties:

• Creates authorization for payment of community care in the Fee Basis Claims System (FBCS) or alternative software system with pertinent information including the community provider's name, address, category of care, obligation number, number of visits, purposeof visit, and length of authorization.
• Provides administrative support to ensure all pertinent information is transmitted to appropriate parties for community care that is authorized under any other funding source.
• Electronically uploads all pertinent clinical and administrative data to a third-party administrator as appropriate.
• Serves as an administrative point of contact in the request, coordination, and authorization for community care consults.
• Works collaboratively with VACC RN Patient Care Coordinators, VACC Program Analysts, other VA staff and Community Care providers.
• Receives, handles, and transfer calls appropriately with regard to telephone inquiries from numerous sources including patients, other VA staff, and community providers concerning items including but not limited to: authorization terms, appointment status and billing/claims status.
• Prepares correspondence to be sent to community providers that includes details about the terms of the authorization, the appointment date and time, and all pertinent clinical data as instructed by the RN Patient Care Coordinator. Prepares correspondence to be sent to patients that includes details about the terms of the authorization, including the provider's name and location and appointment date and time.
• Performs weekly validations of authorizations and input, process, edit and or investigate suspended claims in FBCS to ensure accuracy of authorization entry.
• Inputs or edits community provider information into VISTA as requested by Pharmacy Service.
• Other related duties, as assigned

Work Schedule: Monday - Friday (8am - 4:30pm) or (7:30am - 4pm)
Position Description Title/PD#: Program Support Assistant/PD91909A
Physical Requirements: The work is primarily sedentary. However, there may be some walking, standing, bending, carrying, and lifting light items such as papers, books, and files. No special physical demands are required.

Conditions of employment

• You must be a U.S. citizen to apply for this job
• Subject to a background/suitability investigation
• Selective Service Registration is required for males born after 12/31/1959
• A complete application package; Resume, Transcripts, etc. is required
• 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 identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)

As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your probationary period or trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement.

GS-06 grade level: One year of specialized experience (equivalent to the GS-05 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization. Specialized experience includes:

• Providing administrative support to a team, including but not limited to timekeeping, receiving and responding to phone calls, emails, and other messages, using electronic filing systems, possess the knowledge to research and review available records and locate required documentation form a variety of sources.
• Using various Microsoft Office programs, online database programs, and office equipment.
• Working independently, complying with internal and external deadlines, and assisting in department problem-solving.
• Preparing reports, assisting in planning, reviewing data.
• Following SOP's, directives, and other training, ensuring work is compliant with regulatory procedures.
• Skilled in interpersonal communication is required including the ability to handle agitated and/or confused clients to properly present information about available benefits either determining the nature of their inquiry or needs. Skilled in interpersonal communication is required including the ability to handle agitated and/or confused clients to properly present information about available benefits either determining the nature of their inquiry or needs.
• Knowledge of the privacy program and ensuring health information is kept confidential and protected at all times in accordance with applicable privacy statutes.

Preferred Experience: N/A

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.

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/.

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. Applicants will be referred in the order in which they were received.