The position is located within the Community Care Section of the Business Office, VA New Jersey Health Care System, East Orange, NJ. The primary functions of this position are to authorize and process authorizations for payment of health care services delivered to Veterans and Family members by non-VA Providers and to provide support for the NVCC Program.

Duties

Duties may include but are not limited to: Authorization Examination - 50% Responsible for the proper processing of authorizations falling under the NVCC Program; Checks for accuracy, adequacy of documentation authorizations, compliance with regulations and justification for medical care; Claims are submitted from hospitals, clinics and physicians, laboratories and other vendors as well; Appropriations - 25% Creates each authorization analyzes each to determine propriety of payments; Determines the proper appropriation to be charged and that expenditures are incurred; Resolves discrepancies and/or problems that are associated with the authorization; Prepares correspondence to all parties involved, including letters transmitting adverse decisions or requests for additional information; Verifies cost data and availability of funds; Creates and researches accounting records; Reviews documents authorizing medical care of benefits and determines the proper amount due for services authorized; Account Reconciliation - 25% Determine the adequacy of the authorization and the amount to be paid; Determines the missing requirements and reconstructs incomplete files to allow completion for claim processing; Constructs letters to providers and beneficiaries; Examines authorizations and/or resolves difficult reconciliations requiring an analysis of adjustments and corrective entries; Compiles and verified the accuracy of accounting data to prepare statements, reports and schedules; Inputs authorizations into FBCS, is responsible for accounting measures and obligates the funds ensuring all costs are accurate and complete; and Performs other duties as assigned. Work Schedule: Monday - Friday, 8:00am - 4:30pm 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#: Voucher Examiner/PD18054A 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, 01/22/2024. 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-6 position you must have served 52 weeks at the GS-5. 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-5 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Ability to interpret regulations, policies and procedures to determine appropriate actions; reviews documentation for accuracy, adequacy of documentation, compliance with regulations and justification; resolves discrepancies and/or problems that occur; ability to verify computations of payment figures and accuracy in data entry and calculations; knowledge of medical terminology and the relationship of disease or injury to the treatment rendered; accurate in making and verifying arithmetical computations and adjustments, and in transcribing facts and figures on a variety of supporting documents and forms; perform administrative tasks such as securing missing facts, forms, receipts, or signatures; prepares and submits correspondence; creates, reviews, and processes detailed reports; and ability to create and edit spreadsheets such as Microsoft Excel or similar to ensure accurate records, create reports and to reconcile and track applications received with errors. Note: Experience must be fully documented on your resume and must include job title, series and grades for all federal positions held, duties, month and year start/end dates AND hour worked per week. Failure to do so will results in a Non-Qualification Determination. You will be rated on the following Competencies for this position: AuditingClericalCustomer Service (Clerical/Technical)Data ManagementDecision Making 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: Long periods of sitting in one location are required in completing transactions, using a computer with dual monitors as well as other standard office equipment. 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

There is no educational substitution at this grade level.

Contacts

• Address VA New Jersey Health Care System 385 Tremont Avenue East Orange, NJ 07018 US
• Name: Asaph Blodgett
• Email: [email protected]