This position is in the Foreign Medical Program, Specialty Programs Department (SPD), Veteran and Family Member Programs (VFMP) Directorate, Office of Integrated Veteran Care (IVC), Veterans Health Administration (VHA), Department of Veterans Affairs (VA). The primary function of the position is to review, analyze, and adjudicate claims. These are claims for medical services performed outside of the United States for Veterans with VA rated service-connected conditions.

Duties

PRINCIPAL DUTIES AND RESPONSIBILITIES: Analysis and Processing of Foreign Medical Program Claims Identify improper payments and initiate appropriate recoupment actions Accurately converting all foreign currency to the equivalent amount in United States dollars Perform research via medical reference books, medical dictionaries, online medical websites, coding software, etc. Examine, develop, and evaluate relevant documentation related to claims Knowledge of diagnostics, medical services and procedure coding Ability to understand and make judgements based on the laws and regulations set forth in the program policy. Promotion Potential: 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. Work Schedule: Monday - Friday ( 6:00 am- 4:30 pm) Compressed/Flexible: Available after one year. Telework: Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Claims Examiner/PD43287A and PD43286A Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/26/2023. 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-7 position you must have served 52 weeks at the GS-6. 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. For a GS-8 position you must have served 52 weeks at the GS-7. 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 as described below: Specialized Experience: To qualify, applicants must have one year of specialized experience equivalent to at least the next lower grade (GS-06) in the normal line of progression for the occupation in the organization. Specialized experience is defined as work that involves (1) Performing fact finding procedures in order to fully assess a situation; (2) Gathering information through observation, analysis of records (3) Verifying information to ensure accuracy (4) Making determinations of adherence to laws, regulatory guidance, and agency policies. You will be rated on the following Competencies for this position: Attention to DetailComputer SkillsCritical ThinkingMedical InformationReading 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 primarily sedentary with occasional requirements to walk around in an office building to meet with employees. 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

There is no educational substitution at this grade level.

Contacts

• Address Workforce Management - Community Care 120 SE 6th Street Suite 102 Topeka, KS 66603 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]