The Health Benefit Assistant serves as Patient Services Assistant for the Enrollment/Eligibility section within the Associate Director office at VA Butler Healthcare under supervision of the Health Administration Service Line. The incumbent provides administrative support to the section. Incumbent may be required to work different hours during off tours for Health fairs, Outreaches or other special events.

Duties

Major Duties As a Patient Services Assistant in the Eligibility Unit, the incumbent has primary responsibility for interviewing patients applying for medical benefits. Applications may be received in person, by telephone, by mail, on-line or referral from another VA. Incumbent is responsible for entering demographic, insurance, and income information into the Vista system. This information serves as a base for determining entitlement to medical care as well as bill preparation and collections on all billable episodes of inpatient and outpatient care. Accurate and complete data collection is essential to proper processing of third party collection requirements as mandated by law. Incumbent verifies eligibility/entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, computer hospital inquiry (HINQ) and other means, such as communications with VA Regional Office or VA Records Processing Centers. The process of verifying eligibility is complicated and criteria differs for each type of benefit applied for. The incumbent advises the veterans of their entitlement to various medical benefits and discusses co-payment requirements of veterans in discretionary categories. Extreme tact and diplomacy is required to explain complicated laws in this area. The incumbent is expected to provide exceptional customer service by exceeding the customer's expectations. The incumbent will actively listen to customers with respect and concern; the incumbent will pay attention to the details of the customer's needs and help the customer arrive at a satisfactory solution to the problem. The incumbent will be flexible, adaptive and enthusiastic to exceed the customer's needs. Incumbent monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs as mandated by law. Failure to perform these audits and to timely update the information may result in inaccurate billing of a patient and result in missed crediting of workload visits for the Medical Center, Outpatient Clinics and CBOCs. Impact to the Center and patients are costly and time consuming to correct. Incumbent identifies and collates health insurance information from all applicants for entry to the Vista, copies insurance company enrollment identification cards, researches employers as needed to obtain complete data when applicants do not have complete information. The incumbent is responsible for providing enrollment and eligibility information through outreaches, flu clinics and public interest activities. The incumbent is responsible for providing enrollment and eligibility training to clinical and other administrative staff to assist them in the care and treatment of the Veteran. The incumbent is considered a "subject matter expect" in their Registration packages and is called upon to provide training to new employees or new programs. Performs other related duties as assigned Work Schedule: Monday through Friday 8:00 a.m. to 4:30 p.m. Telework: Not Available Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Asst/ PD00607A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required

Requirements

• You must be a U.S. Citizen to apply for this job
• Designated and/or random drug testing may be required
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to background/security investigation
• Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/01/2023. 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-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Performing eligibility entitlement determinations, conducting intake, registration, enrollment and processing of claims screening applicants, managing various databases, providing guidance related the eligibility process resolving complex eligibility determinations. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have four years of education beyond the high school level. 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 the high school level in excess of 60 credits. You will be rated on the following Competencies for this position: Client OrientationComputer SkillsCustomer Service (Clerical/Technical)Decision SupportFlexibility 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 mostly sedentary; however, there will be some periods of walking, bending, lifting and carrying of medical records frequently required. Occasionally veterans may be angry and potentially violent. Work Environment: The incumbent will be working primarily in an office setting that is open to routine public visitation. Ability to communicate with irate/verbally abusive individuals may on occasion be necessary. Typical safety precautions such as pulling file drawers, proper use of equipment, etc., to be observed. Electronical safety precautions must be observed in working with computers, multi-functional devices, and other office equipment and supplies. Work is primarily performed in a shared office-setting, however, the incumbent occasionally will attend meetings, outreaches, and other obligations at other locations and during off tours. 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 Butler Healthcare 353 North Duffy Road Butler, PA 16001 US
• Name: Paula Schubele
• Phone: 850-710-0150
• Email: [email protected]