This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/474897500. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
OUR MISSION: To fulfill President Lincoln's promise "To care for him who shall have borne the battle, and for his widow, and his orphan" 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 care to Veterans?
Office of Community Care (OCC) is responsible for a broad range of activities to support the delivery of health care benefits for Veterans and their Dependents with health care services external to VA facilities. In addition, this business line plans, manages and supports the Contact Center (CC) enterprise-wide learning and workforce development programs. The Cost Center Team's goal is to provide assistance to the field by leading the transformation of Cost Center business practices, implement health benefits policy, and to support the delivery of quality health care through management of the following programs: Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA); CHAMPVA In-house Treatment Initiative (CITI); Non-VA Medical Care Program; Foreign Medical Program (FMP); Spina Bifida Health Care Benefits Program (SB); Children of Women Vietnam Veterans (CWVV); and supporting emerging programs such as the Camp Lejeune Family Member Program (CLF)MP.
The Pathways Recent Graduates Program provides developmental opportunities for participants to be non-competitively converted to a permanent career-conditional or term position once the recent graduate completes all requirements of the program. Conversion to a Permanent career conditional or Term position is not guaranteed, however, in order to be eligible for conversion to a permanent or term position, Recent Graduates must:
· Successfully complete at least 1-year of continuous service in addition to all requirements of the Program.
· Demonstrate successful job performance.
· Meet the Office of Personnel Management's qualifications for the position to which the Recent Graduate will be converted.
Learn more about this agency07/20/2017 to 08/09/2017
$35,581 - $46,261 per year
GS 05
10 vacancies in the following location:
Not required
No
Permanent
Full-time - Full Time
8
No
OY-17-EDI-1986291-BU
474897500
This position is assigned the organizational title of Customer Service Representative (CSR) under the Chief, Customer Service Center (CSC), of the Department of Veterans Affairs (VA), Veterans Health Administration, and VA Office of Community Care (OCCPC). The primary function of the Customer Service Representative is advising, counseling, reviewing applications and claims and/or responding to requests regarding business processes for all associated health benefit programs which are administered by the OCCPC. This involves personal contacts with the public for the purposes of (1) advising and providing information on benefits and rights; (2) explaining pertinent legal provisions, regulations, and related administrative practices and their application to specific cases; and (3) assisting individuals in developing needed documents and evidence required, or in resolving errors, delays or other problems in obtaining benefits. Duties include but are not limited to:
· Supports telephonic, written correspondence, live CHAT, and/or electronic contacts as the CSC's mission dictates;
· Obtains In-depth knowledge of programs, laws, regulations, and policies, include communicating knowledge to an extremely diverse customer base;
· Develops, examines, adjusts, reconsiders, recommends settlement of various types of claims, receives and processes requests for authorization of healthcare services, supplies and benefits;
· Furnishes routine information concerning rights and benefits with regard to assigned health benefit programs administered by the OCCPC under laws administered by the Department of Veterans Affairs;
· Informs Supervisor of circumstances which would preclude meeting due dates;
· Assists in the testing of new programs, enhancements to existing processes and new initiatives impacting customer service, such as EDI, telephone systems, etc.;
· Works directly with Veterans, beneficiaries, providers and collection agencies in an effort to mitigate or resolve situations in which the Veteran or beneficiary has been placed in an adverse credit situation due to non-payment and/or untimeliness of payment of medical claims;
· Utilizes a variety of readily available guidelines.
Work Schedule: Monday through Friday, an 8 hour shift will be established between 6:00 am - 6:00 pm depending on organizational requirements.
Position Description Title/PD#: Contact Representative/ PD# 04786A
Fair Labor Standards Act: Non-Exempt
Bargaining Unit: 1272
Relocation Expenses: Relocation expenses are not authorized for this position.
Promotion Potential: The full performance level of this position is GS-08. 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.
Physical Requirements: The work is primarily sedentary although some walking, stooping, bending, reaching, and carrying loads weighing up to 20 pounds is required. Use of computer and telephone is extensive.
Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference on the Occupational Questionnaire in the section provided and provide a legible copy of your DD214(s) and/or documentation related to your active duty service which shows dates of service, character of service (honorable, general, etc.), or 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 Veterans Preference" with required proof as stated on the form. For more information, please review the information for disabled Veterans in the application checklist or visit http://www.fedshirevets.gov/job/vetpref/index.aspx.To qualify for this position, applicants must meet all requirements by Wednesday, August 09, 2017
GS-05: SPECIALIZED EXPERIENCE: Applicants must possess at least one (1) year of specialized experience equivalent to at least the next lower grade (GS-04) in the normal line of progression for the occupation in the organization. Specialized experience includes:
· Assist with explaining and advising the basis for payment decisions and reasons for disallowance.
· Assist with explaining payment methodologies used in adjudicating medical claims to resolve questions about allowable amounts and cost shares.
· Assist with examining routine claims for errors and initiates action to correct such errors in accordance with current operational policies.
· Composes responses to routine inquiries in those cases where replies are required.
· Assist with monitoring controlled correspondence suspense system to ensure compliance with due dates.
OR
Applicants may substitute education for the specialized experience required for the GS-05 level. The education must be at least 4 years above high school obtained in an accredited business, secretarial or technical school, junior college, college or university. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work.
Note: 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. (TRANSCRIPTS REQUIRED).
OR
Applicants may also combine education and experience to qualify at the GS-05 level. Equivalent combinations of successfully completed post-high school education and experience may be used to meet total experience requirements at grade GS-05. To calculate, first identify the percentage of required education you have earned. Then identify the percentage of required specialized experience that you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-05. (TRANSCRIPTS REQUIRED)
Note per OPM Qualification Standards: only education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement at the GS-05 level. One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience.
Additional information on the qualification requirements is outlined in the OPM Qualifications Standards Handbook of General Schedule Positions. It is available for your review on OPM's web site at http://www.opm.gov/qualifications/standards/indexes/alph-ndx.asp.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. PLEASE INCLUDE GRADE AND/OR SALARY, MONTH/YEAR TO MONTH/YEAR, HOURS WORKED PER WEEK AND A DESCRIPTION OF YOUR WORK EXPERIENCE SHOWING THAT YOU MEET THE REQUIRED SPECIALIZED 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; 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.
PLEASE NOTE: Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html All education claimed by applicants will be verified by the appointing agency accordingly. 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.
Receiving Service Credit for 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. Per VA Handbook 5011: Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience.
The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan CTAP)
provide eligible displaced Federal competitive service employees with
selection priority over other candidates for competitive service
vacancies. To be qualified you must submit appropriate documentation and
be found well-qualified (have a final rating of 85 or more before any
Veterans preference points) for this vacancy. Information about ICTAP
and CTAP eligibility is on OPM's Career Transition Resources website
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
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.
This job opportunity announcement may be used to fill additional vacancies.
You will be evaluated for this job based on how well you meet the qualifications above.
Your résumé and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.
You will be rated on the following competency factors based upon your application for this position:
1) Ability to explain benefits are coverage to inquirers;
2) Skill counseling, advising and interviewing the general public;
3) Ability to assist with analyzing and evaluating numerous and different types of documents submitted in support of inquiries, reconsiderations, and appeals;
4) Skill in reviewing correspondence and technical documents in order to obtain information.
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.
Applicants will be ranked based on three quality groups, 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;
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.
After the vacancy announcement closes, reviewed applications are
evaluated against the questionnaire responses and placed in the appropriate
quality group. Qualified veterans will be afforded preference by being placed
at the top of the appropriate quality group. Qualifying veterans with a service-connected
disability of 10% or more will be placed at the top of the best qualified
group. The best qualified group is the first to be referred to the hiring
facility for further consideration and possible interview. The remaining groups
may be
referred based on the number of applicants available.
To apply for this position, you must provide a complete Application Package which includes:
All applicants are required to submit the following supporting document type(s):
·Resume
·Transcript
Applicants may also submit the following supporting document type(s),which may not be required for all applicants:
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), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
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.
HOW TO APPLY: All applicants are encouraged to apply online.
To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on Wednesday, August 09, 2017 to receive consideration.
1. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire.
2. Click the Submit My Answers button to submit your application package.
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 USAJOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Details 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 USAJOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
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. During our review, if
your résumé and application package do not support your questionnaire answers,
we will adjust your rating accordingly. After the review is complete, a
referral certificate(s) is issued and applicants will be notified of their
status by email (if provided); otherwise, applicants will receive a
notification letter via the U.S. Postal Service. 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
USAJOBS account and clicking on Application Status. For a more detailed
update of your status, click on more information. Information regarding
applicant
notification points can be found in the USAJobs Resource Center.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/474897500. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
Learn more about
*Only the first 100 applicants who apply for this position will be given consideration and Veterans Preference is applicable. *
This position is being filled under the Pathways Recent Graduates Program. The Pathways Recent Graduates Program provides development opportunities for participants to be non-competitively converted to a permanent career-conditional or term position once the recent graduate completes all the requirements of the program. For more hiring information on Recent Graduates Program please visit https://www.opm.gov/policy-data-oversight/hiring-information/students-recent-graduates/
To be eligible, applicants must meet one of the following requirements:
· Completed all requirements for an associates, bachelors, masters, professional, doctorate, vocational, or technical degree/certificate from a qualifying educational institution within the previous two (2) years on or after August 20, 2015 and before August 20, 2017. OR,
· A Veteran as defined in 5 U.S.C 2108, who was unable to apply within two years of receiving their degree, due to military service obligation, have as much as six years after degree completion to apply.