The Customer Service Specialist positions are in the Office of Finance and reports to the designated Supervisory Program Analyst. The Customer Service Specialist (CSS) conducts reviews in the areas of Community Care coordination and payment of claims related to care in the community to attempt to resolve concerns from Veterans and community providers.

Duties

Performs reviews by examining Veteran(s) medical records, community care authorizations, community payment records, and historical tracking of submitted health care claims. Assists individuals in developing needed evidence and preparing required documents, or in resolving errors, delays, or other problems in obtaining benefits or fulfilling obligations. Communicates with the patient, his/her family, and with clinical and administrative staff, Veteran's Affairs (VA), and private sector to enhance responsiveness in meeting the health care needs of Veteran. Identifies problems or answers questions about entitlement and services that can or cannot be provided and identifies sources of difficulty in obtaining services. Provides explanation regarding Veteran eligibility and/or entitlement to benefits according to the Veterans Benefit Package and the laws and regulations governing VA authority that authorize payment for care in the community. Communicates with the Veteran to assist in filing claims and explain what action is needed to support their claims. Identifies the elements of the clinical or administrative practices that contribute to or create an atmosphere for patient customer dissatisfaction and recommends changes that will reduce or eliminate complaints. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday - Friday; 40 hours per week; TOD to be set based on organizational need. 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. Applicants must live within 50 commuting miles of Cleveland, OH. This position may be authorized for telework upon successful completion on training, supervisor approval and agency policy. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Customer Service Specialist/PD95131A and PD95130A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): 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, 12/15/2023. 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-7 position you must have served 52 weeks at the GS-05. 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. GS-07: You may qualify based on your experience and/or education as described below: GS-07 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience include: 1) Performs reviews by examining Veteran(s) medical records, community care authorizations, community payment records, and historical tracking of submitted health care claims. 2) Identifies problems or answers questions about entitlement and services that can or cannot be provided and identifies sources of difficulty in obtaining services. 3) Provides explanation regarding Veteran eligibility and/or entitlement to benefits according to the Veterans Benefit Package and the laws and regulations governing VA authority that authorize payment for care in the community. 4) Communicates with the Veteran to assist in filing claims and explain what action is needed to support their claims. 5) Performs a variety of support service functions and related work in dispersing information to the public on rights, benefits, privileges, or obligations, and explaining pertinent legal provision, regulation, and related administrate practices and their application to specific cases. OR, GS-07 Substitution of Education for Experience (TRANSCRIPTS REQUIRED): Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 1 full year of graduate level education or superior academic achievement (S.A.A).S.A.A. is based on (1) class standing, (2) grade-point average, or (3) honor society membership.1. Class standing -- Applicants must be in the upper third of the graduating class in the college, university, or major subdivision, such as the College of Liberal Arts or the School of Business Administration, based on completed courses.2. Grade-point average (G.P.A.)-- Applicants must have a grade-point average of:a. 3.0 or higher out of a possible 4.0 ("B" or better) as recorded on their official transcript, or as computed based on 4 years of education, or as computed based on courses completed during the final 2 years of the curriculum; orb. 3.5 or higher out of a possible 4.0 ("B+" or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum. Grade-point averages are to be rounded to one decimal place. For example, 2.95 will round to 3.0 and 2.94 will round to 2.9.3. Election to membership in a national scholastic honor society -- Applicants can be considered eligible based on membership in one of the national scholastic honor societies listed below. These honor societies are listed by the Association of College Honor Societies (external link). Agencies considering eligibility based on any society not included in the following list must ensure that the honor society meets the minimum requirements of the Association of College Honor Societies. Membership in a freshman honor society cannot be used to meet the requirements of this provision. OR; GS-07: Combination of Education and Experience (TRANSCRIPTS REQUIRED): Applicants may also combine education and experience to qualify at this level. You must have an combination of education beyond an Undergraduate degree and specialized experience directly related to the work of the Customer Service Specialist position. GS-09: You may qualify based on your experience and/or education as described below: GS-09 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 include: 1) Identifies the elements of the clinical or administrative practices that contribute to or create an atmosphere for patient customer dissatisfaction and recommends changes that will reduce or eliminate complaints. 2) Investigates complaints, initiates actions, appeals, or changes to rectify the situation, and reports corrective measures taken to parties involved. 3) Gathers, analyzes, and prepares information while applying sound judgment when responding to inquiries. 4) Contributes to vendor recovery while completing complex requests in a timely and efficient manner. 5) Provides consultative services to Veterans, vendors, congressional offices, Veteran Service Organizations, staff, and other stakeholders to facilitate performance improvement. OR; GS-09: Substitution of Education for Experience (TRANSCRIPTS REQUIRED): A master's 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. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. OR; GS-09: Combination of Education and Experience (TRANSCRIPTS REQUIRED): Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and successfully completed Graduate level education directly related to the work of the Customer Service Specialist position. You will be rated on the following Competencies for this position:Client OrientationCustomer ServiceKnowledge ManagementOrganizational Stewardship 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 mostly sedentary. The work environment involves everyday risks or discomforts that require normal safety precautions typical of an office environment. 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 VHA Servicing Human Resources Office - 2 2402 Wildwood Ave Suite 301 Sherwood, AR 72120 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]