This position is located in a Consolidated Patient Account Center in the organization of the Chief Operating Officer with the incumbent serving as the Insurance Verification Supervisor. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions and the integration of VHA and industry best practices.

Duties

Implements processes and procedures for staff to contact insurance carriers to ascertain all benefits the veteran or policyholder is entitled to under his/her health insurance plan. Reviews and evaluates insurance data to determine the necessity to merge like insurance plans and/or companies and/or to add new insurance plans/companies. Provides guidance and assistance for the review of Explanation of Benefits as necessary to identify insurance information. Researches Third Party Joint Inquiry files for prior payments. Reviews Claims Tracking files for proper pre-certification. Reviews insurance company data files for current information and contacts the appropriate insurance carrier representative to complete the process. Responds to phone inquiries from veterans or their family members. Work Schedule: 40 hours per week; Monday-Friday; Tour of Duty to be set based on organizational need. Telework: Authorized after successful completion of training, supervisory approval, and agency policy. Virtual: This is not a virtual position. Position Description/PD#: Supervisory Program Specialist/PD00087A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO):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, 10/20/2023. PROBATIONARY PERIOD: First time supervisors are subject to completion of a one year probationary period. 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-09 position you must have served 52 weeks at the GS-07. 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. 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-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Actively participates in training programs and organizational strategies to identify opportunities to improve customer service and quality. Provides the customer with consistent information according to established policies and procedures. Hears and resolves employee complaints and refers unresolved complaints to higher-level management. Identifies training and developmental requirements and provides and/or obtains the necessary training. Monitors the integrity of the insurance file database by ascertaining that data is timely and accurate. Assures that production requirements are fulfilled and distributes and balances workload among employees in accordance with established workflow or job specialization. Implements processes and procedures for staff to contact insurance carriers to ascertain all benefits the veteran or policyholder is entitled to under his/her health insurance plan. OR; Education (TRANSCRIPTS REQUIRED): Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a masters or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. OR; Combination (TRANSCRIPTS REQUIRED): Applicants may also combine education and experience to qualify at this level. You must have a combination of successfully completed graduate education and specialized experience directly related to the work of the Supervisory Program Specialist position, which may be substituted to meet the experience requirements for GS-09 position. For example, an applicant with 6 months of appropriate specialized experience equivalent to GS-07 (50 percent of the experience requirement for GS-09) and 1 year of successfully completed graduate education (18 semester hours), as is describe above, (50 percent of the education requirement for the GS-09) would qualify for a GS-09 position. You will be rated on the following Competencies for this position: Analytical ReasoningCommunicationCustomer Service (Clerical/Technical)Decision MakingTeaching Others 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 sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort. 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 MACPAC Asheville 730 128 Bingham Rd. Suite #500 Asheville, NC 28806 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]