Clarification from the agency

Open to all U.S. Citizens. Non-citizens may be appointed when it is not possible to recruit qualified citizens. NOTE: The 2-page Resume requirement does not apply to this occupational series. For more information, refer to Required Documents below.

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The incumbent is responsible for interviewing patients applying for medical benefits and managing eligibility and enrollment of Veterans into the VA health care system. Applications may be received in person, by telephone, by mail, on-line or referral from another VA. They will ensure that
applications are processed, finical information (Means Test & Co-Pay Test) is collected, and Health Insurance Coverage is identified and collected via Insurance Capture Buffer (ICB), since insurance collections help supplement services and benefits to enrolled Veterans.

Verifies eligibility/entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, Veterans Information Solution (VIS), DPRIS, VBMS and SHARE applications. The process of verifying eligibility is complicated and criteria differ for
each type of benefit applied for.

Extensive knowledge of the Medical Center and policies is required to respond to inquiries from veterans, Medical Center staff and other agencies regarding applying for care, eligibility, etc.

Accurately generates patient data cards for veterans applying for care using the Veterans Health Identification Card (VHIC) system.

Incumbent monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs as mandated by law.

Incumbent identifies and collates health insurance information from all applicants for entry to the VES, copies or scans insurance company enrollment identification cards, researches employers as needed to obtain complete data when applicants do not have complete information.

Incumbent will also assure that all new veterans to the system are registered within 7 days of receipt of their application


Work Schedule: Monday- Friday, Dayshift
Virtual: This is not a virtual position.
Functional Statement # 91997-A
Permanent Change of Station (PCS): Not Authorized
Financial Disclosure Report: Not required
Recruitment Incentive: Not Authorized

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.
• Must be proficient in written and spoken English.
• 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.
• Must pass pre-employment physical examination.
• 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.
• As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period (OR INSERT "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 INSERT "trial period"), your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
  

Qualifications

Grandfathering Provision: May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

Basic Requirements:

• Experience and Education:
  • Experience: Six months experience of clerical, office, customer service, or other administrative work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR,
  • Education: One year above high school; OR,
  • Experience/Education Combination: Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable.

• Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.
• Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations.
• Ability to communicate tactfully and effectively, electronically, by phone, in person], and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns.
• Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care.
• Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc.
• Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians.

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 MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: You must include qualifying specialized experience in mm/yyyy to mm/yyyy format on your resume and indicate Full-Time or Part-Time (if Part-time, must include # of hours worked per week). AND, if you have held a Government position, that position's grade level MUST be listed on your resume

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.

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.

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.