Health Benefits Assistant - Veterans Affairs, Veterans Health Administration : Job Details

Summary The position is located at the Jonathan M. Wainwright Memorial VA Medical Center, Walla Walla, Washington (VAWW), servicing Veterans residing in a 42,000 square mile primary service area within VISN 20 Northwest Network. The incumbent is responsible for a wide range of assignments and provides administrative support to Member Services Unit and the clinical staff recovery aspects of this position have a direct impact of the facility. Responsibilities Responsible for interviewing patients applying for medical benefits. Applications may be received in person, by telephone, by mail, on-line or referral from another VA. Incumbent is responsible for entering demographic, insurance, and income information into the VistA system. This information serves as a base for determining entitlement to medical care as well as bill preparation and collections on all billable episodes of inpatient and outpatient care. Accurate and complete data collection is essential to proper processing of third party collection requirements as mandated by law. Verifies eligibility/entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, computer hospital inquiry (HINQ) and other means, such as communications with VA Regional Office or VA Records Processing Centers. The process of verifying eligibility is complicated and criteria differ for each type of benefit applied for. Incumbent advises the veterans of their entitlement to various medical benefits and discusses co-payment requirements of veterans in discretionary categories. Extreme tact and diplomacy is required to explain complicated laws in this area. Functions as the single administrative contact for a client during any one visit to the VA Walla Walla. Incumbent is the initial contact point for Veteran accessing the VA system for the first time, or re-accessing the system after an absence from VA Care. The incumbent receives, determines needs, entitlements, and coordinates a client's visit from arrival to departure, ensuring all administrative and clinical details have been completed before an applicant leaves the facility. When necessary, the incumbent will make telephonic contacts with the client to follow-up and complete details from a previous visit. Greets and receives applicants and determines his/her status in the VA system. In the case of a new patient, the incumbent must determine eligibility based on the correct application of current regulations, directives and CBO guidance governing entitlement to medical benefits. This also includes reviewing all available documentation and data bases, such as, HINQ, DD-214, VIS, etc. Advises the veteran of his/her eligibility status and enrollment Priority Group for VA health care, explaining his/her billing co-payment status, including how his/her private insurance may affect his/her VA billing co-payments. The incumbent also will advise the veteran if he/she is determined to be ineligible of their appeals rights and procedures in writing and assist them to submit a notice of disagreement. Work Schedule: Monday - Friday, 8:00am - 4:30pm, with occasional PM, weekend and Holidays shifts Position Description Title/PD#: Health Benefits Assistant/PD80270A Telework: Not Authorized Virtual: This is not a virtual position Physical Requirements: The work normally involves mental rather than physical exertion. The work is generally sedentary, but requires some bending, walking, standing, lifting and carrying patient records and various reports to various areas throughout the medical center campus. Reading from CRT for long periods of time and accessing information from various computer systems as necessary. Requirements Conditions of Employment Qualifications To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement. GS-05 grade level: One year of specialized experience (equivalent to the GS-04 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: knowledge of all aspects of Business Office/Health Administration Service programs and knowledge of how they interrelate to all other medical center services and programs. Knowledge of medical and administrative record system, Privacy Act and Freedom of Information Act, as they relate to the release of information on patients. Ability to interpret and apply rules, regulations, policies, and procedures and to make sound decisions, using good judgment. Ability to deal with variety of individuals with tact and diplomacy. Knowledge of using a personal computer Word, Excel, and various VISTA packages such as Integrated Billing, Registration, Appointment Management, Enrollment, and Patient Demographics software applications. OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school graduation or equivalent (TRANSCRIPTS REQUIRED). OR Combination: Applicants may also combine education and experience to qualify at the GS-05 level. You must have a combination of specialized experience and education beyond the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement. One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience (TRANSCRIPTS REQUIRED). You will be rated on the following Competencies for this position: Client Orientation Computer Skills Customer Service Technical Credibility 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. 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: 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. 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. Participation in the seasonal influenza program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities. 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 well-qualified, applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors if applicable, and must be proficient in most of the requirements of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website which can be found at 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. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.