Health Benefits Assistant (Eligibility and Enrollment)

Health Benefits Assistant (Eligibility and Enrollment)

01 Aug 2020

Health Benefits Assistant (Eligibility and Enrollment)

    Duties

    Summary

    Incumbent provides support to the VA's revenue cycle. The Incumbent is responsible for identifying and verifying patient insurance, liaison with insurance carrier, and maintaining an accurate and functional data system of insurance carriers, benefits, and patient information in order to maximize reimbursements ofthird party claims.

    Responsibilities

    The Health Benefits Assistant facilitates and performs identification, verification, and data entry of insurance and insurance related information in support of the revenue process that include the development, examination, and settlement, of medical and dental claims. This may include: obtaining information required to identify and initiate a wide variety of billing activities through personal and/or telephone contact and correspondence, capturing information necessary to enable all cases with potential medical care cost recovery to be identified, and capturing insurance information on all veterans who hold third party health plans. Incumbent may be required to review health plans with veterans, including explaining insurance issues such as deductibles, copayments, and VA's role in insurance recovery, and with third party carriers. Incumbent will ensure all necessary paperwork and data is completed and entered and will develop and implement internal audit systems to ensure accurate insurance data capture. Systemic reviews, continuous monitors, special studies, and various recurring and non-recurring reports will be developed and used. Incumbent will compile and prepare reports as needed to reflect program effectiveness and inform management of program status. Incumbent ensures compliance with all laws, regulations, and policies impacting the unit, and develops and maintains a system to demonstrate compliance. Incumbent composes correspondence which may include, but is not limited to, requests for additional information for pending cases, clearly explaining departmental policies, rules and regulations. The incumbent will serve as a resource to other facility staff on eligibility and administrative policies.

    Work Schedule: 8 Hours between the hours of 6:00am-6:00PM. Must be willing to work weekends, irregular work hours and extended hours. The candidate must be willing to be assigned to other related services and/or locations, if necessary.
    Telework: Not Available
    Virtual: This is not a virtual position.
    Position Description/PD#: Health Benefits Assistant (Eligibility and Enrollment)/PD11639A
    Relocation/Recruitment Incentives: Not Authorized
    Financial Disclosure Report: Not required

    Travel Required

    25% or less - You may be expected to travel for this position.

    Supervisory status

    No

    Promotion Potential

    None

  • Job family (Series)

    0303 Miscellaneous Clerk And Assistant

  • Requirements

    Requirements

    Conditions of Employment

    • You must be a U.S. Citizen to apply for this job
    • Designated and/or random drug testing may be required
    • Selective Service Registration is required for males born after 12/31/1959
    • 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

    Qualifications

    To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/31/2020.

    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-05 position you must have served 52 weeks at the GS-04. 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:

    • Specialized Experience: You must have one 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. Examples of specialized experience would typically include, but are not limited to: Enters data into computer using varies software programs, composes correspondence such as: requests for additional information for pending cases, clearly explaining departmental policies, rules and regulations, and ensures all necessary paperwork and data is accurately completed. OR,

    • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have Four (4) years of education above the high school level in any field. OR,

    • Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond high school.

    You will be rated on the following Competencies for this position:

    • Communications
    • Customer Service

    • Self Management



    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 sedentary. Typically, the employee sits comfortably to do the work. However, there may be some walking; standing; bending; carrying of light items such as papers, books, small parts; or driving an automobile, etc. No special physical demands are required to perform the work.



    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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

    Additional information

    Receiving Service Credit or 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.

    Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator.

    The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/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/.

    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.

    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.

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

    If you are unable to apply online view the following link for information regarding an Alternate Application.


    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.

    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 contact for 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.

    Background checks and security clearance

    Security clearance

    Other

    Drug test required

    No

    Position sensitivity and risk

    Non-sensitive (NS)/Low Risk

    Trust determination process

  • Required Documents

    Required Documents

    To apply for this position, you must provide a complete Application Package which includes:

    • Resume



    The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. 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), SF-50's (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.

    • Cover Letter
    • DD-214/ Statement of Service

    • Disability Letter (Schedule A)

    • Disability Letter (VA)

    • Other (1)

    • Performance Appraisal

    • Proof of Marriage Status

    • Resume

    • Separation Notice (RIF)

    • SF-15

    • SF-50/ Notification of Personnel Action

    • Transcript



    SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):

    • Most recent SF-50 if you are a current or former Federal employee
    • An SF-50 showing 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
    • Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.

    • Examples of appropriate SF-50's include:

      • Within grade increases at the highest grade held; or
      • Promotions with an effective date more than one year old; or
      • SF-50's at the highest grade held with an effective date more than one year old.

    Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and 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 Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit http://www.fedshirevets.gov/job/vetpref/index.aspx.

  • Benefits

    Benefits

    A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.


Help

This job is open to

  • Career transition (CTAP, ICTAP, RPL)

    Federal employees who meet the definition of a "surplus" or "displaced" employee.

  • Federal employees - Competitive service

    Current or former competitive service federal employees.

  • Individuals with disabilities

  • Veterans

Clarification from the agency

Open to Status Eligible Candidates

Related jobs

Job Details

  • ID
    JC4438102
  • State
  • City
  • Source
    US Department of Veterans Affairs
  • Date
    2020-07-10
  • Deadline
    2020-09-08
  • Category

Jocancy Online Job Portal.