The incumbent serves as Advanced Medical Support Assistant, advising on health benefits, in the Eligibility and Enrollment Section at CTVHCS. The incumbent is primarily responsible for the intake and administrative processes for Veterans and beneficiaries applying for medical services at our Health Care System or to any of its Community Bases Outpatient Clinics (CBOCs) and satellite clinics. Attention to detail is mandatory for the duties involved in the position.

Duties

Incumbent interviews and registers applicants to determine eligibility and legal entitlement of applicants for health care, including assignment into the appropriate enrollment priority group. Applications may be received in person, by mail, by internet, by fax, or by referral from another VA facility. Verifies eligibility using various methods, including: income assessments, military discharge documents, hospital inquiry (HINQ), benefits delivery network (BDN), Veteran information solutions (VIS), and other means such as communications with a VA Regional Office. Administers income assessments (means test). Advises and counsels Veterans and their beneficiaries or representatives of financial obligations, co-pay requirements, and their rights to appeal. Deals with and resolves complex eligibility, co-pay, and insurance questions that arise. Displays adaptability in dealing with a wide range of individuals as necessary. Explains to each individual the specific conditions or actions that could affect their co-pay status or eligibility for benefits. Informs Veterans of their responsibility to report changes. Incumbent is responsible for gathering, entering, and updating demographic, employment, insurance, and income verification into the Enrollment System (ES), Veteran Integrated Software Technology (VistA), and other related programs. Incumbent captures specific types of eligibility such as OEF/OIF/OND social work appointments, new patient orientation/education appointments, and phone or video appointments if required. This also requires answering phones that are on an Automatic Call Distribution (ACD) system. Incumbent may be assigned to process electronic health care applications and/or determine eligibility and schedule appointments for Veterans on the New Enrollee Appointment Request (NEAR) report. When appropriate by regulation, the incumbent uses the Electronic Wait list (EWL) and takes necessary actions to schedule Veterans appropriately and as soon as access to care is available. The incumbent deals with a variety of benefits and/or obligations (i.e. medical benefits, co-pay requirements, medication benefits, dental benefits, special transportation, and travel benefits) and special registries (i.e. agent orange, Camp Lejeune, burn-pit, psychosis and other mental illnesses, etc.). Reviews particular circumstances of each individual (i.e. military history, marital status, financial situation, medical conditions, etc.) to apply the regulatory requirements that will best meet the Veteran's needs. Processes claims for hardship determinations, catastrophic disability, beneficiary travel deductible waivers, and appointment/inpatient stay copay waivers. This includes researching for information and informing persons of alternative options. Receives mental health commitments form physicians to admit Veterans into inpatient mental health care. This includes processing the request for local county court systems. Incumbent is responsible for processing request for Veteran Health Identification Cards (VHIC) upon request. This includes taking photographs of Veterans using the VistA VHIC program and submitting to a contractor to complete and send the VHIC card to Veterans. Incumbent also receives completed VHICs from the Health Eligibility Center (HEC) that are returned for bad addresses with the expectation cards will be mailed to the Veteran or destroyed by the facility. Acts as a resource regarding eligibility issues for the Health Care System staff, Veteran Service Organization representatives, and other requesting organizations. Routinely conducts outreach events at different locations to assist in capturing Veterans transitioning from active duty military. On an ongoing basis, discusses the most frequent problems involving contacts with, and the processing of, Veterans, and makes recommendations of possible solutions to the supervisor, advising him/her of the advantages and disadvantages of proposed operating policy changes in the section. The incumbent must be able to effectively communicate with a variety of individuals, including physicians, nurses, technical support staff, Veterans and Veterans' families. Routinely provides administrative processing in emergency situation such as patients being directly admitted to the Emergency Department with immediate needs. Performs other related duties as assigned. Work Schedule: Compressed/Flexible:Monday - Friday 7:30 a.m. - 4:00 p.m. or 8:00 a.m. - 4:30 p.m. Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Basic Requirements: Citizenship. Citizen of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.g.). Experience and Education. Experience. Six months experience of clerical, office, customer service, or other administrative work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR, Education. One year above high school; OR, Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. Certification. None required. Grandfathering Provision. All MSAs employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series, and grade held, [which] are [a] part of the basic requirements of the occupation. Foreign Education. To be creditable, education completed outside the U.S. must have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and such education must have been deemed at least equivalent to that gained in conventional U.S. programs. Physical Requirements. See VA Directive and Handbook 5019. 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 3.j. 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 the basic requirements for employment listed in paragraph 3 above, the following education and experience criteria must be met when determining the grade of candidates: Medical Support Assistant (Advanced), GS-6 Experience. One year of experience equivalent to the GS-5 grade level. Examples of experience include but not limited to: independently performs a full range of duties [related to the delivery of healthcare services in an inpatient or outpatient setting. Advises clinical staff on current administrative processes. The MSA is responsible for answering phones, greeting patients, relaying messages to appropriate staff inside or outside of the unit, scheduling appointments, including interpreting and verifying provider orders in accordance with VHA national scheduling guidelines. Assignments at this level include, but are not limited to: scheduling, canceling, re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources; participating in huddles with other MSAs and/or clinic staff to determine the daily needs of the clinic, monitoring both inpatient and outpatient appointments in areas of responsibility; verifying and updating demographics and insurance information when patients check-in for appointments. Coordinates administrative functions relating to emergency and non-emergency transfers to other VA facilities or private hospitals and determines appointment type based on the patient's eligibility status (i.e., TRICARE, sharing agreements, collaterals, research patient, VA employee, etc.). Demonstrated Knowledge, Skills, and Abilities. Candidates must demonstrate [all of] the KSAs below: Ability to collaborate and communicate [with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. Preferred Experience: Customer service/interpersonal skills (Face-to-Face, telephone, written) 1+ years experience working in administrative/clerical setting 1+ years experience in office automation (ability to use and navigate between various types of office equipment and software) Organization skills Multitasking skills Adaptability References: VA Handbook 5005/117, PART II, APPENDIX G45. MEDICAL SUPPORT ASSISTANT QUALIFICATION STANDARD, GS-0679 The full performance level of this vacancy is GS-06. The actual grade at which an applicant may be selected for this vacancy is a GS-06. Physical Requirements: The work is sedentary. Some work may require movement between offices, hospitals, warehouses, and similar areas for meetings and to conduct work. Work may also require walking/standing, in conjunctions with travel to and attendance at meetings and/or conferences away from the work site. Incumbent may carry and lift light items weighing less than 15 pounds.

Education

Education is not required for this position.

Contacts

• Address VA Central Texas Health Care System 1901 Veterans Memorial Drive Temple, TX 76504 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]