The Health Benefit Assistant works as an advisor for the Enrollment Services Section of Health Administration Services (HAS) here at the Coatesville VA Medical Center, all its Community Based Outpatient Clinics, and Vet Center. The incumbent makes eligibility determinations for VA healthcare which requires an extensive knowledge of laws, directives, policies and procedures.

Duties

The major duties of the Health Benefit Assistant include but are not limited to: Screen, advise, and assist Veterans and other beneficiaries seeking and receiving medical treatment. Subject matter experts to the HAS Section Chiefs and support the management information components of all health eligibility related programs. Provides advice, problem resolution, and administrative support for eligibility issues related to healthcare services. Knowledge of pertinent laws, regulations, polices, guidelines and procedures is required. Entering data and information when necessary, but also reviewing reports, records and statistical computations for accuracy. Involved in an extremely complex blend of computing technology, medical information, communication skills and leadership qualities in a rapidly changing environment. He/she must possess vast computer knowledge in creating and capturing data. Interviews and registers applicants to determine eligibility and legal entitlement of applicants for health care, including assignment into the appropriate enrollment priority group. Verifies eligibility using various methods, including: income assessments, military discharge documents, Hospital Inquiry (HINQ), Veterans Benefits Management System (VBMS), Veteran Information Solutions (VIS) and other means such as communication with VA Regional Office. Administers income assessments (means tests). 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. 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 in their demographics, insurance, and other significant factors. Work Schedule: FT 8:00 am - 4:30 pm Compressed/Flexible: not available Position Description/PD#: Health Benefits Assistant/PD02135A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not approved Permanent Change of Station (PCS): Not Authorized

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/06/2023. 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-5 position you must have served 52 weeks at the GS-4. 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. 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: Interacting courteously and respectfully with all internal and external customers Meets and greets customers to determine the specific need Maintains adherence with all workplace security policies and regulations ensuring work completed done within established guidelines Responds to customer requests and follow up Performing administrative clerical duties Determining eligibility for benefits Interpreting policy and regulations 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 in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical 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 the high school level. NOTE: Only education beyond the second year can be used in combination with specialized experience to qualify for this grade. You will be rated on the following Competencies for this position: Analysis and Problem SolvingCustomer Service (Clerical/Technical)Manages and Organizes InformationStandardsTechnical Competence 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 performed in an office setting and is primarily sedentary. May require lifting and carrying of light loads (e.g.files, records etc.). 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 Coatesville VA Medical Center 1400 Black Horse Hill Road Coatesville, PA 19320 US
• Name: Laura Batcheller
• Phone: 720-576-3315
• Email: [email protected]