This position is located in a Consolidated Patient Account Center (CPAC) in the organization of-the Chief Operating Officer (COO) with the incumbent serving as the Insurance Verification Supervisor. The CPAC Is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions, and the integration of VHA and industry best practices.

Duties

Duties Include but are not limited to: The Incumbent serves as the Insurance Verification Supervisor and as such is responsible for the following: Provides management guidance, direction and supervision to the CPAC's Insurance Verification program operations. Implements processes and procedures for staff to contact insurance carriers to ascertain all benefits the veteran or policyholder is entitled to under his/her health insurance plan. Assures that staff analyzes, interpret and insure timely input of all information gathered during phone conversation with Insurance carrier representatives into the VA insurance database. Assures that staff establishes rapport and convey a courteous and businesslike attitude when conversing with Insurance carrier representatives. Monitors the integrity of the insurance file database by ascertaining that data is timely and accurate. Reviews and evaluates insurance data to determine the necessity to merge like insurance plans and/or companies and/or to add new- insurance plans/companies. Analyzes insurance information and data to determine, when appropriate, to delete outdated Insurance plans and/or companies, taking all necessary steps to insure valid data is merged/saved prior to deletion. Provides guidance and assistance for the review of Explanation of Benefits (EOB) as necessary to identify insurance information. Researches Third Party Joint Inquiry files for prior payments. Reviews Claims Tracking files for proper pre-certification. Examines patient insurance files for accurate/current data. Reviews insurance company data files for current information, and, In most cases, must contact the appropriate insurance carrier representative for further assistance to complete the process. Assigns and reviews work on a daily, weekly or monthly basis. Assures that production requirements are fulfilled and distributes and balances workload among employees in accordance with established workflow or Job specialization. Assures the timely accomplishment of work, monitors status and makes analytical determinations to maintain established priorities and goals. Plans work, sets and adjusts short-term priorities, and prepares schedules for the completion of work. Work is assigned based on individual and/or office priorities. Incumbent identifies training and developmental requirements and provides and/or obtains the necessary training. Hears and resolves employee complaints and refers unresolved complaints to higher-level management. Approves and schedules leave. Establishes performance standards and requirements and evaluates employee performance. Other duties as assigned. Work Schedule: Monday - Friday, 8:00am to 4:30pm Telework: Yes, according to agency policy Virtual: This is not a virtual position. Position Description/PD#: Supervisory Program Specialist/PD73214A 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, 07/24/2023. Time-In-Grade Requirement GS-9: 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-9 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 and/or education as described below: Specialized Experience GS-9: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include but is not limited to: Planning and monitoring status of work, assuring timely completion of work; Establishing performance standards and requirements to evaluate employee performance; Identifying training and developmental requirements and providing/or obtaining the necessary training; Hearing and resolving employee complaints, and experience approving and scheduling leave. (NOTE: This experience must be well documented in your resume)-OR- Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree or LL.B or J.D., if related. 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 only graduate education in excess of the amount required for the next lower grade level may be used to qualify applicants for positions at grades GS-9. You will be rated on the following Competencies for this position: Leadership Communication Analytical Reasoning 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: Work is a mixture of an office environment and a large clerical/administrative office complex. 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.

Contacts

• Address VA NCCPAC Madison 8001 Terrace Ave Middleton, WI 53562 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]