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Insurance Specialist

Department of Veterans Affairs
Veterans Benefits Administration
Insurance Service

Summary

The incumbent serves as an Insurance Specialist on the Quality Assurance staff. The staff is responsible for the oversight of the Insurance Quality Assurance program.

Overview

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Accepting applications
Location
3 vacancies in the following location:
Work site options
Telework eligible
Yes—as determined by the agency policy.
Remote job
No
Relocation expenses reimbursed
No
Salary
$68,013 - $106,982 per year
Pay scale & grade
GS 9 - 11
Promotion potential
11
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Occasional travel - You may be expected to travel for this position.
Appointment type
Permanent
Supervisory status
No
Federal service type
This job is in the Competitive Service
Represented by a union
No
Drug test
No
Security clearance
Other
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Jobs require a background check and some require a security clearance. The type depends on the job.
Background check type
Financial disclosure required
No
Some jobs require financial disclosure to identify conflicts of interests.
Announcement number
310-27-JP-13090404-NBU
Control number
889392500

This job is open to

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Clarification from the agency

This vacancy announcement is open ONLY to current, permanent Philadelphia Insurance Service employees and current/former VA employees who are CTAP eligible.

Duties

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Specific duties include:

  • Conducts in-depth reviews of the Insurance Policy holders Services and Insurance Claims divisions task inputs to ensure the accuracy of Operations processing and disbursements. As part of those reviews, makes recommendations to improve the Insurance Program's overall Quality Assurance program as it relates to disbursements and policy procedures. These recommendations may have a good deal of impact throughout the Insurance program and may represent significant departures from established work practices.
  • Analyzes computer generated listings of insurance transactions to examine for possible fraudulent activities. Monitors computer generated listings to verify the appropriateness of certain account transactions.
  • Analyzes transactional histories, source documents and other documentation in cases where fraud or inappropriate processing of insurance transactions is suspected.
  • Periodically conducts formal training to newly assigned personnel or training on new procedures to the Quality Assurance Staff, and refresher training to Operations staff.
  • Advises and assists lower grade Insurance Specialists in Operations on more difficult cases they may encounter and provide refresher training for such.
  • Assists the supervisor with feedback on performance reviews on lower grade and/or new employees. Provides input to the supervisor for performance appraisals and supervisory evaluations.
  • Performs work independently utilizing judgment and follows assignments through to completion, prepares reports and recommendations to the Assistant Director and/or Staff Chief(s).
Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. The grade progression for this position is GS-9/11.

Work Schedule: Full time, Monday through Friday
Compressed/Flexible: Available (6:00am - 6:00pm)
Telework: This position is eligible for situational (ad hoc) telework only. The selectee is required to report to the official duty station each scheduled workday. Telework may be approved only on a case-by-case basis with supervisory approval. Routine or recurring telework is not authorized for this position.
Virtual: This is not a virtual position.
Position Description/PD#: Insurance Specialist; PD39230A and PD39231A
Relocation/Recruitment Incentives: Not Authorized
Financial Disclosure Report: Not Required

Requirements

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Conditions of employment

As a condition of employment for accepting this position, you will be required to serve a 1-year probationary 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, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Additional Conditions of Employment are as follows:
  • 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 or trial period
  • Subject to background/security investigation
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements 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.

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement:10/24/2026.

TIME-IN-GRADE REQUIREMENT: As a current Federal, GS employee you must meet time-in-grade requirements by the closing date of this announcement.

  • For a GS-09 position you must have served 52 weeks at the GS-07 level.
  • For a GS-11 position you must have served 52 weeks at the GS-09 level.
The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows 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.

Examples of appropriate SF-50s to include which show TIG requirements have been met include:
  • Within grade increases (WGI) at the highest grade held; or
  • Promotions with an effective date that occurred more than one year from the closing date of the job opportunity announcement; or
  • Most recent appointment.
NOTE: Do not submit Award, Data Element, Change in Tenure, or General Adjustment SF-50s, as they do not provide sufficient information and will not be accepted for the purpose of verifying TIG.

MINIMUM QUALIFICATION REQUIREMENT: You may qualify based on your experience and/or education as described below:

GS-09 Grade Level:

Specialized Experience: You must have at least 52 weeks of specialized experience equivalent to at least the next lower grade (GS-7) in the normal line of progression for the occupation in the organization. Specialized experience is defined as:
  • Knowledge of and skill in applying methods, principles, and practices relating to the analysis of issues and problems of a procedural and/or factual nature;
  • Ability to conduct research to gather clear-cut information and apply standardized analytical methods and techniques to accurately assess gathered information; and
  • Evaluate/analyze the task inputs to ensure accuracy.
OR

Education: Applicants may substitute education for the experience required for the GS-09 level. A master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or an LL.B. or J.D., if related.

OR

Combination of Specialized Experience and Education: Applicants may also combine education and experience to qualify at the GS-09 level: Equivalent combinations of specialized experience and graduate education. To compute, divide your total months of qualifying experience by 12. Then divide your semester hours of graduate education beyond two years by 18. Add the two percentages. The total percentage must equal at least 100% to qualify.

GS-11 Grade Level:

Specialized Experience: You must have at least 52 weeks of specialized experience equivalent to at least the next lower grade (GS-9) in the normal line of progression for the occupation in the organization. Specialized experience is defined as:
  • Experience that may have been gained in technical assignments and review of case work that involved the application of laws, rules, regulations or procedures involving the Life Insurance program; and
  • Maintenance and upkeep of VA Life Insurance Accounts, responsibility for examination, investigation, authorization and verification of VA life insurance claims or other related programs.
OR

Education:
Applicants may substitute education for the experience required for the GS-11 level. Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related.

OR

Combination of Specialized Experience and Education: Applicants may also combine education and experience to qualify at the GS-11 level: Equivalent combinations of specialized experience and PH.D. graduate education. To compute, divide your total months of qualifying experience by 12. Then divide your semester hours of graduate education beyond two years by 18. Add the two percentages. The total percentage must equal at least 100% to qualify.

Volunteer Experience: 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.

Full vs. Part-Time Employment: Full-time employment is considered to be at least 35 hours per week. Part-time experience will be credited on a pro-rated basis; when including part-time employment in your resume you must specify the average hours worked per week.

Physical Requirements: The work is basically sedentary.

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

Education

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: https://www.ed.gov/about/initiatives/international-affairs/recognition-of-foreign-qualifications.

You may submit unofficial transcripts when applying. However, if you are selected for the position, you will be required to provide an official transcript or a statement from the institution (e.g., from the registrar, dean, or other appropriate official) or equivalent documentation prior to the start date.

Additional information

The Career Transition Assistance Plan (CTAP) provide eligible displaced 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 your current position, grade level, and duty location) and be found well-qualified (have a final rating of 85 or more) for this vacancy. 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/.

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.

This job opportunity announcement may be used to fill additional vacancies.

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 (TJO). Please visit the Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP), https://www.va.gov/EMPLOYEE/documents/The-Fair-Chance-to-Compete-Act.pdf

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review: Procedures for Requesting a Reasonable Accommodation for Online Assessments. (https://appsupport-usastaffing.opm.gov/hc/en-us/sections/45063131363475-Reasonable-Accommodation-Information)

For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

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. You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Attention to Detail
  • Customer Service
  • Decision Making
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reading Comprehension
  • Reasoning
  • Self-Management
  • Stress Tolerance
  • Teamwork
  • Technical Competence: Uses knowledge that is acquired through formal training or extensive on-the-job experience to perform one's job; works with, understands, and evaluates technical information related to the job; advises others on technical issues.
  • Arithmetic: Performs computations such as addition, subtraction, multiplication, and division correctly using whole numbers, fractions, decimals, and percentages.
  • Self Management: Sets well-defined and realistic personal goals; monitors progress and is motivated to achieve; manages own time and deals with stress effectively.
  • Reasoning: Identifies rules, principles, or relationships that explain facts, data, or other information; analyzes information and makes correct inferences or draws accurate conclusions.
Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on an assessment may also result in your removal from consideration.

To preview the application questionnaire, click the following link:https://apply.usastaffing.gov/ViewQuestionnaire/13090404

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 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.

Veterans Benefits Administration

OUR MISSION: "To fulfill President Lincoln's promise to care for those who have served in our nation's military and for their families, caregivers, and survivors." How would you like to become a part of a team providing compassionate care to Veterans?

The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families, and other beneficiaries.

The Values are Integrity, Commitment, Advocacy, Respect, and Excellence ("I CARE").

As a VA professional, your opportunities are endless. With many openings in the multiple functions of VA, you will have a wide range of opportunities and leadership positions at your fingertips.

Agency contact information

Janelle Phillips
Phone
(313) 471-3888
Email
janelle.phillips@va.gov
Address
Philadelphia VBA Regional Office
5000 Wissahickon Ave
Philadelphia, PA 19144
US

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https://vacareers.va.gov/

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