The Lead AMSA HBA Outreach Coordinator position serves as the Lead Clerk for enrollment & eligibility outreach. Incumbent primarily responsible for coordinating outreach event to determining eligibility and entitlement to VA Healthcare benefits, ensuring that all eligible applicants are eligible and correctly enrolled and registered. Health Benefits Advisor performs clerical work in support of patient admissions, patient transfers, beneficiary travel, and decedent affairs.

Duties

Ensures that all incoming public inquiries and staff mail is properly opened, sorted into established categories for distribution to appropriate units and staff. Ensure all original claim forms are scanned in the FBCS package. Review and save data on all claims and uploaded in to the FBCS Verify Model. Compose correspondence relative to the patient's application for care including letters advising veterans of ineligible status and request for proof of military service. Ensure that health benefits advisors complete scanning of admissions packages, registration packages, administrative documentation concerning decedent affairs and general correspondence for patient informational updates within the John D. Dingell VAMC. Estimate and report on expected time of completion of work and maintain records of work accomplishments and time expended and prepare production reports as requested; instructs employees in specific tasks and job techniques and makes available written instructions, reference materials, and supplies. Give on the job training to new employees in accordance with established procedures and practices maintain a current knowledge and answer questions of other employees on procedures, policies, directives, etc. and obtain needed information or decisions from supervisor on problems that occur; check on work in progress or spot checks work not requiring review, e.g. filing or direct services, and review completed work to see that supervisor's instructions on work sequence, procedures , methods, and deadlines have been met Amends or rejects work not meeting established standards, refer to supervisor questions or matters not covered by standards and problems in meeting performance standards; inform employees of available services and employee activities; resolve simple, informal complaints of employees and refer others to supervisor; report to supervisor on performance, progress and training needs of employees and on behavior problems; provide information to supervisor as requested concerning promotions, reassignment, recognition of outstanding performance, and personal needs. Communicates and interacts with patients, clinicians, internal and external customers in a manner which is appropriate to cognitive, emotional, and chronological maturation needs of the adult and/or geriatric patient. Provides claims development for all types of eligibility requests for inpatient and outpatient treatment as well as other special programs (i.e. Prosthetics, Dental services, Nursing Home Care, Camp Lejeune Water Contamination, Champ-VA DoD sharing agreement activities, non-DoD sharing, agreements and/or contracts, and Medical Care Cost Recovery etc). Communicate with non-VA medical facilities; facilitate secure message processes with the patients and medical staffing teams; participate in team huddles/meetings to manage and plan the administration for patient care. Obtains all key information needed, including but not limited to complete and accurate demographic information, health insurance information, worker's compensation information, etc. Interviews and inputs application information into the VISTA system and obtains all information required for patient processing (10-10ez applications, means test information, private insurance information, patient admissions, etc). Responsible for ensuring all veterans in the database eligible for enrollment are properly enrolled through the Health Eligibility Center and all registration are Complete with no missing data (inconsistence). This will be accomplished through monitoring of the local patient database and providing requested report to the Registration Supervisor on a weekly basis or as needed. Interprets and fully understands all eligibility in order to make initial determinations whether veteran/or non-veterans meet legal/contractual requirements for medical care and is familiar with government documents, such as DD214, to help make such determination. Advise patients on national VA Enrollment, the Uniform Benefits package, and non medical benefits. Directs staff and assists in scheduling and processing all Urgent Care and Emergency Room appointments and ensuring that patient information is processed, placed on medical documentation, and patient identification bands in a timely and accurate manner. Responsible for performing administrative follow up actions from team meetings and huddles; ensuring that patient vesting is stressed upon enrollment; and informing providers about shared patients who have multiple providers (in multiple VAMCs or in the Community). Work Schedule: Monday-Friday; 8am-4:30pm Compressed/Flexible: Not available Telework: Not available Virtual: This is not a virtual position. Functional Statement #: 91859-0 Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency . MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, part II, chapter 3, section A, paragraph 3j. (1)Experience. Six months experience of clerical, office or other work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; or (2)Education. One year above high school; or (3)Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: In addition to meeting the Basic Requirements, the applicant must meet item a, b, and c as well.GS-7 Lead MSA (a) Experience. One year of experience equivalent to the next lower grade level (GS-6). (b) Assignment. The Lead MSA [is responsible for the coordination of Advanced MSA assignments and workflow found in an interdisciplinary unit. The Lead MSA is responsible for daily workload assessments, assigning work, and assuring proper staffing coverage; evaluating training records; and determining training needs of MSAs to provide support across interdisciplinary settings. The Lead assists the unit with complex and non-standard procedures, including clinical flow processes related to access to care across multiple clinics, specialties, and/or community resources. Assignments at this level include, but are not limited to: ensuring accurate and timely scheduling of appointments; providing guidance to staff members, to include changes in policies and procedures; creating and maintaining employee work schedules; and acting as a liaison among Advanced MSA staff, patients, and other interdisciplinary staff to resolve day-to-day conflicts.] For all assignments above the full performance level, the higher-level duties must consist of significant scope, administrative independence, complexity (difficulty) and range of variety as described in this standard at the specified grade level and be performed by the incumbent at least 25% of the time. (c) Demonstrated Knowledge, Skills, and Abilities. Candidates must demonstrate the KSAs below: 1. Advanced knowledge of medical terminology and a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or community resources. 2. Ability to utilize numerous advanced patient systems in support of multiple clinics in an interdisciplinary setting 3. Ability to organize work, set priorities, and delegate tasks/responsibilities in order to meet deadlines. 4. Skill in communicating with individuals to obtain the desired effect and coordinating with a variety of interdisciplinary care team staff 5. Ability to provide staff development and training. 6. Ability to manage staffing requirements, manage workflow priorities, and adjust the flow of work to meet team and patient needs? This includes the ability to follow-up on pending issues and demonstrate an understanding of the impact of incomplete work across multiple clinics IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. References: VA Handbook 5005/117 Part II, Appendix G45 The full performance level of this vacancy is GS-7. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-7. Physical Requirements: The work is primarily sedentary. Typically, the employee may sit comfortably to do the work. However, there may be some walking; standing; bending; carrying of moderate items such as papers, book etc. No special physical demands are required to perform the work. Light Lifting under 15 pounds; reaching above shoulder; use of fingers' both hands required; walking .5 hours per day; standing .5 hours per day; specific visual requirements - 20/20 vision required for both eyes (correction, lenses, glasses accepted); depth perception; ability to distinguish basic colors; ability to distinguish shades of colors: hearing (aid permitted). Environmental Factors - dust, working closely with others and working alone

Education

IMPORTANT: 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 John D Dingell Department of Veterans Affairs Medical Center 4646 John R Street Detroit, MI 48201 US
• Name: Latasha Loyd
• Phone: (313) 409 3775
• Email: [email protected]