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Supervisory Program Specialist-Insurance Verification

Department of Veterans Affairs
Immediate Office of the Assistant Secretary for Human Resources and Administration
735 Consolidated Patient Account Center, Chief Operating Officer Insurance Verification Department

Summary

This position is located in a Consolidated Patient Account Center (CPAC) in the organization of the Chief Operating Officer with the incumbent serving as the Insurance Verification Supervisor. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions, and the integration of VHA and industry best practices.

Overview

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Accepting applications
Location
2 vacancies in the following location:
Work site options
Telework eligible
No
Remote job
No
Relocation expenses reimbursed
No
Salary
$62,729 - $81,553 per year
Pay scale & grade
GS 9
Promotion potential
None
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Not required
Appointment type
Permanent
Supervisory status
Yes
Federal service type
This job is in the Competitive Service
Represented by a union
No
Drug test
No
Security clearance
Not Required
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
CCLQ-13100792-27-KV
Control number
891350200

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Duties

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Duties:

  • Implements processes and procedures for staff to contact insurance carriers.
  • Reviews claims tracking files for proper pre-certification.
  • Examines patient insurance files for accurate/current data.
  • Provides guidance and assistance for the review of Explanation of Benefits (EOB) as necessary to identify insurance information.
  • Monitor the integrity of an insurance file database by ascertaining that data is timely and accurate.
  • Communicates/coordinates daily with the Utilization Review (UR) Nurses, collections staff, or billing specialist.
  • Independently prepares reports, memorandum and other written products.
  • Researches Third Party Joint Inquiry files for prior payments

Work Schedule: Monday-Friday 8:00-4:30P
Telework: Not Authorized
Virtual: This is not a virtual position.
Position Description/PD#: Supervisory Program Specialist-Insurance Verification/PD35889A and PD35889A
Relocation/Recruitment Incentives: Not Authorized
Critical Skills Incentive (CSI): Not Approved
Permanent Change of Station (PCS): Not Authorized
PCS Appraised Value Offer (AVO): Not Authorized


Requirements

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Conditions of employment

  • You must be a U.S. Citizen to apply for this job
  • To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.
  • Selective Service Registration is required for males born after 12/31/1959
  • Physical Requirements: The work is performed mainly in a sedentary manner, however, walking, standing, reaching and bending is required.
  • 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 (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 supervisory 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, 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, 11/09/2026.

Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also 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. 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.

Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.

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

GS-09 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:

  • Lead and coordinate program activities by assigning, monitoring, and reviewing work to ensure timely accomplishment of organizational goals and mission requirements.

  • Apply knowledge of insurance programs, claims administration, policies, and regulations to provide technical guidance, resolve operational issues, and support program effectiveness.

  • Communicate effectively with employees, customers, and management officials by presenting information, addressing concerns, facilitating collaboration, and providing clear recommendations on program matters.

  • Ensure adherence to established policies, regulations, and procedures through oversight of program operations, analysis of performance outcomes, and implementation of process improvements to enhance efficiency and customer service.


Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level.

OR

Education (TRANSCRFIPT REQUIRED): Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work.

OR

Combination (TRANSCRIPTS REQUIRED):
Applicants may also combine education and experience to qualify at this level. You must have equivalent combinations of successfully completed graduate education and specialized experience directly related to the work of the Supervisory Program Specialist position, which may be substituted to meet the experience requirements for the GS-09 position.

You will be rated on the following Competencies for this position:
  • Accountability
  • Customer Service
  • Decisiveness
  • Flexibility
  • Interpersonal Skills
  • Problem Solving
  • Resilience


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 performed mainly in a sedentary manner, however, walking, standing, reaching, and bending is required.

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

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://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Additional information

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.

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 the Procedures for Requesting a Reasonable Accommodation for Online Assessments.

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

The Interagency Career Transition Assistance Plan (ICTAP) and 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 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 ICTAP and 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/.

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.

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 for this position:

  • Accountability
  • Customer Service
  • Decisiveness
  • Flexibility
  • Interpersonal Skills
  • Problem Solving
  • Resilience


Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. 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. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.

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.

During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.

Immediate Office of the Assistant Secretary for Human Resources and 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" - by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate whole health care to Veterans?

Agency contact information

Keshia Vaughn
Phone
2027466568
Email
keshia.vaughn1@va.gov
Address
Central Consolidated Patient Accounts Center
Department of Veterans Affairs
Leavenworth, KS 66048
US

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https://vacareers.va.gov/

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