The purpose of the position is to serve as an Advanced Medical Support Assistant (AMSA), also known as a Health Benefits Advisor, in the Health Administration Section at the VA Pacific Islands Health Care System, Akaka CBOC. The position is aligned under the Akaka, Supervisory Business Manager.

Duties

As an Advanced Medical Support Assistant in the Eligibility and Enrollment section at the VA Pacific Islands Health Care System (VAPIHCS) the incumbent has the primary responsibility for interviewing patients applying for medical benefits, co-pay exemption testing, Income Verification Match for Veterans, and making determination of eligibility and priority placement. Processes New Enrollee Application Requests (NEAR). Applications may be received in person, by telephone, by mail, on-line or referral from another VA. Incumbent is responsible for entering demographic, insurance, and income information into the VistA system. This information serves as a base for determining entitlement to medical care as well as bill preparation and collections on all billable episodes of inpatient and outpatient care. Accurate and complete data collection is essential to proper processing of third-party collection requirements as mandated by law. Incumbent coordinates and schedules new patient appointments for newly enrolled Veterans. Functions : Verifies eligibility/entitlement for benefits of all applicants using various methods including income assessments (means test), military discharge documents (DD214), computer hospital inquiry (HINQ), Veterans Information Solution (VIS) and other means, such as communications with VA Regional Office or VA Records Processing Centers. The process of verifying eligibility is complicated, and criteria differ for each type of benefit applied for to include dental care, long term care and Fee Basis programs. The incumbent advisesthe veterans of their entitlement to various medical benefits and discusses co-payment requirements of veterans in discretionary categories. Extreme tact, diplomacy and privacy are required to explain complicated laws in this area. Accurately identify Third Party Liability and reimbursable insurance and enters insurance data through the Insurance Capture Buffer (ICB) on all new registrations and when updating means test. Extensive knowledge of the Medical Center and policies is required to respond to inquiries from Veterans, Medical Center staff and other agencies regarding applying for care, eligibility, etc. Accurately process Long Term Care applications and financial assessments, assist Veterans with Financial Hardship paperwork for relief from medical copayments and Catastrophic Disabilities applications for higher priority placement. Knowledge of requirements for processing of name changes, and Care Giver Support. Assist Veterans and eligible family members in ordering replacement DD214's online using the VETREC website. Incumbent will also assure that all new veterans to the system are registered within 5 days of receipt of their application. New eligible applicants will immediately be scheduled into their first new patient appointment at the appropriate facility in relation to their area of residence and will have their Veteran Health Identification Card (VHIC) picture taken. Incumbent schedules appointments in VistA/VSE in accordance with VHA national scheduling rules and established clinical guidelines on all new registrations. Work affects the accuracy and reliability of medical records, which in turn affect the outcome of research efforts, outcome of the internal and external audits, quality of information physicians and support staff receive to ensure that all benefits as possible are available to the Veterans we serve. The incumbent communicates and interacts with patients in a manner which is appropriate to cognitive, emotional, and chronological maturation needs of the adult and/or geriatric patient. Incumbent must adhere to fire, safety, and security requirements. In the performance of official duties, the employee has regular access to printed and electronic files containing sensitive data which must be protected under the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA procedures. The employee is responsible for (1) protecting this data from unauthorized release or from loss, alteration, or unauthorized deletion, and (2) following applicable regulations and instructions regarding access to computerized files and user ADP security as set out in the computer access agreement which the employee signs Assures that all appropriate VA forms are used correctly, and regulations followed. Work Schedule: Monday - Friday; 7:30am - 4:00pm; possible Saturday rotation Compressed/Flexible: Not Authorized Telework: Not eligible for Telework Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency: Advanced Medical Support Assistants must be proficient in spoken and written English in accordance with VA Policy. Creditable Experience Knowledge of MSA Practices. To be creditable, the experience must have demonstrated the knowledge, skills, and abilities (KSAs) associated with current MSA responsibilities [or an equivalent administrative patient support role in a non-VA medical inpatient or outpatient setting]. Experience satisfying this requirement may be paid/non-paid employment as [an] MSA or [an equivalent position in a non-VA hospital or clinic setting]. Quality of Experience. Qualifying experience must be at a level comparable to MSA experience [or equivalent administrative clinical support role in a non-VA medical inpatient or outpatient setting] at the next lower grade level. For all assignments above the full performance level, the higher-level duties must consist of significant scope, administrative independence, complexity (difficulty), and a range of [varieties] as described in this standard, at the specified grade level and be performed by the incumbent at least 25% of the time. Part-Time Experience. Part-time experience as [an MSA or equivalent administrative patient support in] a [non-VA medical inpatient or outpatient setting] is creditable according to its relationship to the full-time workweek. For example, [an] MSA employed 20 hours a week, or on a 1/2-time basis, would receive [one] full-time workweek of credit for each [two] weeks of service. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation). Grade Determinations: For GS-06 In addition to the basic requirements you must demonstrate that you possess one year of specialized experience at the next lower grade level (GS-05). Preferred Experience: Experience gained while working in a medical office, hospital, inpatient/outpatient clinic, Ancillary Service, Call Center, Care of Community Care, Consult Scheduling, Direct Scheduling, Interdisciplinary Coordinated Care Delivery Models, PACT TEMLETS, Patient Systems, Radiology/Imaging/Nuclear Medicine, Specialty Clinics, Veterans Appointment Request, VistA Scheduling Graphical User Interface (VS GUI), Ward . Applying administrative judgment, the use of wide range of clinical flow processes relating to access to care across multiple clinical, specialties. Recommends changes to existing clinic procedures based on current guidelines. You will be rated on the following Knowledge, Skills, and Abilities based on your application for this position: Please make sure that each is addressed in detail in the body of your resume. I. Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. II. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. III. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. IV. Advanced knowledge of he technical healthcare process including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient healthcare portals as it relates to access to care. V. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care [administrative functions] to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. VI. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. References: VA Handbook 5005, PART II, APPENDIX G45 Medical Support Assistant VA Qualification Standards. Can be found in the local Human Resources Office. The full performance level of this vacancy is GS-06. The actual grade at which an applicant may be selected for this vacancy is GS-06. Physical Requirements: This is primarily a sedentary position. See VA Directive and Handbook 5019

Education

IMPORTANT: 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 Spark M Matsunaga Department of Veterans Affairs Medical Center 459 Patterson Road Honolulu, HI 96819 US
• Name: Lizbeth Torres
• Phone: (415) 221-4810 X24760
• Email: [email protected]