The Financial Manager Specialist is located in a Consolidated Patients Account Center (CPAC) in the organization of the Deputy Director of Operations with the position serving as the Facility Revenue Manager (FRM) located on-site at a medical facility. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by consolidation of billing and collection activity.

Duties

The duties of the position include: Monitoring changes in Veteran eligibility that support the need to reset medications based on new SC/SA and/or means test changes where the Veteran is no longer medication co- payment required. Monitoring Veterans are credited for prescriptions filled at facilities for the purpose of the yearly co-payment cap by completing the Push Rx Copay Cap transaction. Monitoring held charges and days on hold to ensure that co-payments are released timely and appropriately. Developing and providing monthly reports to the Health Information Management (HIM) Chiefs - Business Office Manager (or comparable position), Compliance. Monitoring the closing and creation, set-up, naming conventions and stop code assignments of new clinics within a facility and determines their designation as High Dollar such as surgeries, chemotherapy, dialysis, etc. Reviewing clinical information and obtains third-party insurer authorization for continuation of care and payment. Keeping abreast of clinical activities that have the potential to negatively affect revenue. Performing revenue validation functions such as filtering processes to determine billable encounters, tort fees for/workers compensation, repetitive services, prosthetics, service connected, or non-service connected determination, tracking and pre-authorization of mental health encounters. Participating in software testing and provide feedback for product improvement. Analyzing information from the Non-VA/Fee Program through the Fee Basis Claims Software (FBCS), Fee Payment Processing System (FPPS) TriWest PC3 Portal. Utilizing Community Care Pre-Authorization Tool (CCPAT), Enrollment System (ES), Computerized Patient Record System (CPRS), CHOICE Share-point and Community Care Reimbursement System (CCRS) to ensure the VA can seek reimbursement of dollars expended to pay for private-sector treatments for Veterans. Providing revenue utilization review support, addressing revenue reported issues, and addressing OI&T issues as needed. Analyzing potential revenue sources within a Medical Center and ensuring that all MCCF billings and collections guidelines are strategically followed. Assessing the financial position of the revenue program and areas affecting revenue generation. Developing and implementing programs to effectively manage patient accounts, identifying potential billable cases, and optimizing collections. Performing auditing duties associated with either financial or operational audits of the revenue program and reviews the program's degree of compliance with sound fiscal internal control and quality management. Advising and consulting with counterparts and/or officials with higher authority concerning problems involving work in the revenue program and its' impact on education, training needs for staff. Educating Veterans on service connection (SC) and/or special authority SA, repayment plans, hardships and waivers. Preparing reports that identify noncompliance with regulations, inefficient operations, or improper practices and develops constructive recommendations for improvements within the audit segment. Communicating frequently with Attorneys, legal offices, and Regional Counsel regarding legal cases. Coordinating and managing daily operations of revenue functions at an assigned medical center. Performing quality reviews to ensure staff are completing workload accurately and timely based on acceptable standards. Participating in ad hoc meetings, committees, and workgroups with Chiefs of Service, Administrative Officers, Department Heads, Compliance, and revenue. Collaborating with Mental Health and Veteran Services to identify Veterans at High Risk and assist with billing concerns. 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, 8:00 am - 4:30 pm. Compressed/Flexible: Not available. Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework after obtaining a Fully Successful status. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Financial Management Specialist/PD57798A and PD87429A 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, 08/14/2023. GS-9 Requirements GS-9 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-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: 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 are not limited to: monitoring changes in Veteran eligibility and co-pay charges; interpreting fee program information; consult with counterparts concerning programs and training requirements, communicating with outside entities for regarding operations within the service. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have two (2) years of progressively higher-level graduate education or masters or equivalent graduate degree or LL.B. or J.D., in a related field of the position to be filled. 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 a bachelors degree. GS-11 Requirements GS-11 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-11 position you must have served 52 weeks at the GS-9. 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-9 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: monitoring changes in Veteran eligibility and co-pay charges; analyzing fee program information and understanding of community care pre-authorization; coordinating with internal and external counterparts concerning programs and training requirements, communicating with outside entities for regarding operations within the service. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree, or 3 full years of progressively higher-level graduate education leading to such a degree, or LL.M., 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 a masters or graduate degree. You will be rated on the following Competencies for this position: Health Information Exchange Medical Information Computer Skills Technical Competence Communication Leadership 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: Duties are primarily performed in an office setting and are mostly sedentary with some physical exertion, such as walking, bending, stooping, and stretching. 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 CPCPAC Leavenworth 735 4101 S 4thSt., Trafficway Leavenworth, KS 66048 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]