The position is at the full performance level located at the VA Greater Los Angeles Health Care System (VAGLAHS), Los Angeles, CA in the Corporate Compliance Service, directly under Office of the Director, and specifically part of Business Integrity and Compliance in Corporate Compliance. This individual is a key member of the Office of Integrity and Compliance (OIC) Program and reports directly to the Office of Integrity and is a integral part of an effective Compliance Program.

Duties

Duties: Responsible for completing programmatic auditing of facility-wide revenue process and non-VA care. Administer extensive auditing and/or tracking, the position ensures that all policies, procedures, and guidance are implemented with respect to facility billing to third party payers (such as insurance carriers). Perform facility-wide compliance auditing in identified areas of concern. Maintain positive working relationships across healthcare center for interdisciplinary audits and identifying potential facility risk areas. Collect data and/or report the multiple evaluation and management code assignment to ensure accurate workload is reported as well as aid in the reduction of inaccurate billing. Independently prepares complete reports, summarizes analysis, audit finding, and/or presents information to multiple forums: executive leadership, committees, and facility-wide training events. Collect and/or ensures availability of supplementary documentation to support. Deliver subject matter expertise in billing and coding functions within the facility. Develop procedures and/or tracking systems for establishing, assessing, and calculating data and information related to administrative, operational, fiscal, and clinical services. Initiate and develop concepts relating to review and evaluation of health records and related revenue cycle processes, purchased care processes, and business systems. Gather information about the assigned organization or single-issue function scheduled for audit and determines the overarching audit objectives. Provide subject matter expertise to the Office of Integrity and Compliance Officer, Medical Center Director, Service Line Leaders, and medical center staff. Implement comprehensive compliance audits to determine root cause of findings, validating findings with process owners, and preparing audit deliverables. Work Schedule: Full Time, 40 Hours a Week, Monday to Friday, 7:30am to 4:00PM Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Program Analyst (Compliance Program Analyst/Auditor)/PD13669O 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, 11/28/2023. 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-11 position you must have served 52 weeks at the GS-09. 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. GS-11 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-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: healthcare organizations, interpret VHA policies, regulations, medical record/coding principles, methods, practices, procedures to determine impact on healthcare programs, analysis, audits, findings, and recommendations. (must be in resume). OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or LL.M., if related. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and Only graduate education. You will be rated on the following Competencies for this position: AccountabilityAdministration and ManagementCommunicationQuality Assurance 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 mostly sedentary. Some walking and bending may be required to gain access to files. The position is required to travel and attend functions during other than normal duty hours. The work does include high stress with frequent short deadlines. 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 Greater Los Angeles Healthcare System 11301 Wilshire Boulevard Los Angeles, CA 90073 US
• Name: Joseph Parra
• Email: [email protected]