This position is in the Business Office at the VA Boston Healthcare System. This is a full time position at 40 hours per week.

Duties

Medical Administrative Specialist will serve as the medical center expert on a variety of special program determinations such as hardship Waivers, Co-pay, catastrophic eligibility, fee basis, allied veterans, and other special eligibility cases such as combat veterans, purple heart, etc. Prepares policy procedures and manuals for local use. Supervises a variety of lower graded clerical staff in several different functions of patient benefits and Data management. Major duties are as followed: Program administration: Develops local policies and procedures and serves as the expert for a variety of special programs administered by Patient Services (hardship waivers, catastrophically disabled, Allied veterans, Combat veterans, sharing agreement personnel, etc). Handles difficult cases that may be referred by other personnel and Congressional inquiries. Analyzes problems that hinder the timely determinations needed by veterans and develops appropriate remedies by making workflow and organizational changes, revising procedures, coordinating computer or jurisdictional problems, and coordinating changes with other affected organizational units in the medical center. Technical operations: Conducts review and analyses and makes recommended decisions on difficult eligibility determinations such as those involving Hardship Waivers to develop a financial status report by gaining information from the veteran or family members in order to conduct an up to date means test, determine current years income less the applicable deductions, and makes determination based on the eligibility criteria and determines effective date. Serves as the Catastrophically Disabled Coordinator reviewing, assembling packages and letters for the Chief of Staffs' approval. Provides advice to the veteran, family members, v SO, Veterans agents, etc. on all the programs administered by Patient Services. Reviews all types of automated reports for accuracy such as error reports, inconsistency reports, status pending, registrations, etc. Corrects problems with HEC registration/eligibility data by reviewing eligibility determinations that may be in conflict with other medical centers' input. Handles all types of appeals and serves as the installation expert and presents information with the Chief of Patient Services and the deciding judge. Handles problems generated by the regional office on Comp & Pen cases that impact on eligibility determinations. On service connected increases, works with billing to insure information is updated and appropriate update and refund actions are initiated. Manages the quality control program for the service. Reviews quality and quantity performance and sets standards for the organizational subunits. Monitors performance against standards and makes adjustments as necessary .Prepares reports on results and plans for implementing methods to improve the indicators. Supervisory duties: Performs supervisory personnel management duties over certain functions.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement,05/27/2024. 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 11 position you must have served 52 weeks at the GS-09 level. 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. 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: Formulates, presents, executes, and analyzes organizational budgets. Plans, develops and conducts internal review studies in deficient areas including records management, and privacy issues. Utilization Review and Health Information activities, privacy, records management and the new scanning program. Interviewing and counseling Veterans concerning the law and regulatory guidelines on their enrollment and eligibility for health care benefits. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a 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. The degree must be in a field that equipped the applicant with the knowledge, skills, and abilities to perform the duties of the Medical Administration Specialist position. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond one year of graduate education.

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 VA Boston Healthcare System 940 Belmont Street Brockton, MA 02301 US
• Name: Christian DiNoia
• Phone: 774-826-4923
• Email: [email protected]