The primary function of this position is to make eligibility determinations for VA healthcare which requires an extensive knowledge of VA laws, directives, policies and procedures. They will also be responsible for running data reports for unverified status of applications, incomplete encounter management errors due to any administrative data input and updating demographic information.

Duties

The incumbent has varied range of duties related to the enrollment and eligibility and benefits and travel to determination of Veterans Maintain a through and up to date knowledge of the rules and regulations, and policies and procedures in determining eligibility of Veterans for VA Healthcare Advises applicant of the health care benefits they are legally entitled to in person or over the phone, initiates administrative process for establishing care, and notifies appropriate healthcare personnel accordingly Respond to technical question regarding patients' administrative rights and situational eligibility for healthcare and provide patients with administrative advice and guidance Provide Veterans both verbal and written information regarding non-medical benefits and refers Veterans to area VBA Benefits Counselors for claims as appropriate Respond to complex questions involving regulations and/or beneficiary entitlements and communicated results to patients, families, agency employees, and Veterans' organizations Handle questions and/or concerns ensuring that quality service is rendered in a timely, complete and empathetic manner Verifies· eligibility for care utilizing primary sources including but not limited to the Health Eligibility Center (HEC), Hospital Inquiry HINQ, VIS and ES military discharge papers, DD214 Communicates through data systems, verbally and electronically with the REC on a regular basis by providing accurate eligibility and enrollment information Serves as the Veteran's initial contact with the Medical Center. He/ She enrolls the Veteran by inputting information from the 10-1 0EZ Form into VISTA. In addition to the advisement of health care benefits Processes re-enrollment into the system and assist Veterans. He/ She connect Veterans with other program areas as needed Correspond with national contacts to resolve processing and conflicts that require action the Heath Eligibility Center Interacts with the entire Enrollment System Redesign (ESR) website to electronically enroll Veterans, a process recently mandated down to the local level in 2015, by inputting all required registration information Other duties as assigned Work Schedule: Monday -Friday; 8:00 am - 4:30 pm Virtual: This is not a virtual position. Driver's License: Current, Valid Driver's License Position Description/PD#: Health Benefits Assistant/PD01660A and PD01660A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/13/2023. 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-05 position you must have served 52 weeks at the GS-04. 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: Knowledge of laws and regulations; customer service skills, interacting with patients and hospital staff, respond to customer requests, updating and verifying demographic information, creating electronic medical files, knowledge of Microsoft Work, Microsoft Excel and Outlook; provide administrative support to staff, 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 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 . You will be rated on the following Competencies for this position: ClericalCustomer Service (Clerical/Technical)Manages and Organizes InformationTechnical 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: The work is primarily a sedentary position. Typically, the employee sits comfortably to do the work. But, there may be some walking, standing, bending, carrying of light items such as papers, books, small items, etc. No special physical demands are required to perform the work. Concentration and sustained performance under potential stress of accuracy and deadlines is required because of factors involved in completion of various complex work assignments. 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/. ****All required documentation must be uploaded before the announcement closes, to support eligibility.**** Failure to submit documentation will constitute the application being categorized as incomplete and therefore ineligible for referral.

Education

A legible 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.

****All required documentation must be uploaded before the announcement closes, to support eligibility.****

Failure to submit documentation will constitute the application being categorized as incomplete and therefore ineligible for referral.

Contacts

• Address Wilmington VA Medical Center 1601 Kirkwood Highway Wilmington, DE 19805 US
• Name: Katrina Paul
• Phone: (412) 822-3584
• Email: [email protected]