About the Position: This Health Care Referral Coordinator (Office Automation) position is located at DHA National Capital Market, Army Health Clinic, Ft. Myer

Duties

Provide authoritative explanations of Medicare and Supplemental Care Program policy, regulations, and procedures. Review referrals for completeness of required medical information and verifies that service is a covered benefit under Medicare, Medicaid, Supplemental Care and CHAMPUS standards. Manage all requests for Durable Medical Equipment supplied by civilian and military resources. Review and verify claims and assist in budget execution and reporting for supplemental care funds. Assist individuals in obtaining health care benefits and preparing appeals when benefits are denied. Provide advice, counseling, and training on TRICARE, CHAMPVA, Medicare, Medicaid, and Delta Dental procedures and benefits. Compile and maintain daily and monthly reports regarding statistics of the patients affiliated with the Referral Coordination Service.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position requires the completion of a pre-employment Physical Examination and an annual examination thereafter to ensure the continued, required level of physical health and ability or fitness to perform the duties of the position.
• This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Tier 1 security investigation or access for the duration of employment. A background investigation and credit check are required.
• This position has a mandatory seasonal influenza vaccination requirement and is therefore subject to annual seasonal influenza vaccinations.
• This position requires the incumbent to have tuberculosis testing.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
• This position has been designated Mission Essential. In the event of severe weather conditions or other such emergency type situations the incumbent is required to report to work or remain at work as scheduled to support mission operations.

Qualifications

Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. 30 Percent or More Disabled VeteransCurrent Civilian Employees of the Defense Health Agency (DHA)Current Department of Defense (DOD) Civilian Employee (non-Army)Domestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel WorkforceInteragency Career Transition Assistance PlanLand Management Workforce Flexibility ActMilitary Spouses, under Executive Order (E.O.) 13473Non-Department of Defense (DoD) TransferPeople with Disabilities, Schedule APriority Placement Program, DoD Military Reserve (MR) and National Guard (NG) Technician EligiblePriority Placement Program, DoD Military Spouse Preference (MSP) EligiblePriority Placement Program, DoD MR and NG Preference Eligible Tech Receiving Disability RetirementPriority Placement Program, DoD Retained Grade Preference EligibleVeterans Recruitment Appointment (VRA) In order to qualify, you must meet the experience requirements described below. 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; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Specialized Experience: One year of specialized experience equivalent to the GS-05 grade level in the Federal Service which includes: use of automated systems such as the Defense Eligibility Enrollment Reporting System (DEERS) and the Composite Health Care System (CHCS) to access information and assist beneficiaries with routine matters; assisting beneficiaries with basic health benefits questions and with obtaining benefits; reviewing and/or verifying routine claims; and reviewing non-complex referrals for completeness and accuracy. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). Proficiency Required: This position requires a qualified typist. A qualified typist can type 40 words per minute based on a 5-minute sample with three or fewer errors. Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted. You will be evaluated on the basis of your level of competency in the following areas: Customer Service (Clerical/Technical)Decision MakingManages and Organizes InformationOrganizational Awareness Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06).

Education

This job does not have an education qualification requirement.

Contacts

• Address JT-DHA-DD83DJ DHA NCR MARKET DO NOT MAIL Various Locations, DC 00000 US
• Name: Army Applicant Help Desk