The position is at the full performance level located in the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), at the San Diego VA Medical Center (VAMC) in the Health Administration Service (HAS). The primary purpose of the Enrollment Specialist is to perform a variety of duties pertaining to enrollment, eligibility verification, health benefits, Financial Assessments (Means Test), and the revenue programs.

Duties

Enrollment & Eligibility The incumbent is responsible for obtaining and processing enrollment documentation, updating demographics, establishing eligibility of Veterans for health benefits. Provides front desk reception and management, assisting Veterans with the Combat Veteran Screening Process; as an eligibility, enrollment and health benefits consultant, provides an explanation of VA Health Benefits and reimbursement information on all patients requesting care within the VA San Diego Healthcare System (VASDHS). Completes clerical work in support of care and treatment provided to eligible patients such as, receiving patients to be admitted, updating patient eligibility and demographic information. Utilizes patient care access portals such as the Veteran's Lifetime Electronic Record enrollment and education (VLER), in-person authentication and patient guidance for MyHealtheVet/Secure Messaging, Clinical Data Repository/Health Data Repository (CHDR), enrollment and patient education for e-benefits; supports enrollment process improvements. Explains features of online health access portals such as password set up and enrollment, how to access health logs online and checking the status of benefits claims. Communicates to patients, their families, and agency employees the specific entitlement to benefits, either in person or as a part of the Telephone Advice/Assistance Line. Clarifies admission and outpatient policies to patients, their families, agency employees, and veteran's organizations. Researches and responds to all questions regarding patient rights, responsibilities, and eligibility for medical/dental care. Receives and processes applications for admission and outpatient treatment. Provides eligibility determinations and information to the medical/dental staff. Makes copies, files documentation, and enters information into the computer. Answers eligibility and payment questions, provides information, provides guidance and procedural information, and initiates action as appropriate. Obtains all key information needed and initiates medical/dental administrative processing of basic requests and forms. Incumbent stays abreast of pertinent information such as changes in laws, regulations, and/or other relevant directives which impact basic medical/dental benefits entitlements. Data Entry/Reports Performs work involving the collection, compilation, and/or tracking of data and statistical information in support of Health Administration Service. Assists in the review and reporting of data/statistical results of program/project studies conducted by others. Follows established protocols for incoming data, organizes computerized data sets, and retrieves computerized data. Reviews documents, reports and/or applications for omissions and inconsistencies, and ensures data entries are complete and accurate; coordinates documents, such as enrollment applications and other data on VHA forms. Enters requisite information into the automated tracking system/ES. Maintains an established tracking system of program-specific data to track pending items such as unverified eligibility. Financial Assessments (Means Test)/ Revenue Programs Performs a basic review of the data for completeness and accuracy; generates a variety of reports. Evaluates documents, such as Means Tests/Financial Assessment and other data on VHA forms; Means Test/Financial Assessment administration, with established threshold limitations, is used by the incumbent to validate a Veteran's income to determine eligibility. Coordinates incoming data from a variety of sources. Reviews documents, reports and/or applications for omissions and inconsistencies and ensures data entries are complete and accurate. Enters requisite information into the automated tracking system/ES. The incumbent identifies Veterans that experience financial setbacks or have a significant financial burden when accepting their financial assessment during the Explanation of Benefits which includes a Q&A session. Work Schedule: Monday - Friday, Between 7:00am-7:00pm Position Description Title/PD#: Program Support Asst (OA)/PD11194A Virtual: This is not a virtual position. Telework: Not Available Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required 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, book, small parts, or driving and automobile, etc. No special physical demands are required to perform the work.

Requirements

• You must be a U.S. citizen to apply for this job
• Subject to a background/suitability investigation
• May serve a probationary period
• Selective Service Registration is required for males born after 12/31/1959
• A complete application package; Resume, Transcripts, etc.
• Selected applicants will be required to complete an online onboarding process
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement. GS-05 grade level: One year of specialized experience (equivalent to the GS-04 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization. Specialized experience includes: Collection and tracking of data and statistical information to support the Health Benefits and Enrollment programs. Research and review documentation to Determine eligibility for health benefits. Knowledge of computer software programs equivalent to Microsoft, Excel, Outlook, and Word processing, etc., and skill to formulate correspondence, make web inquiries, research information, enter data into VHA proprietary systems; Ability to perform review of data for accuracy and make changes and corrections to data as necessary; and to generate a variety of reports. Communication skill sufficient to gather and provide information, verbally and in writing, to Veterans and/or their support team, other staff members and the general public. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school. 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 4 years of high school as described above. 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.

Education

Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school.

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.

Contacts

• Address San Diego VA Medical Center 3350 La Jolla Village Drive San Diego, CA 92161 US
• Name: Tonya Stewart
• Phone: 858-232-7825
• Email: [email protected]