The incumbent's work impacts the administrative aspect of patient care including access, scheduling/coordinating appointments using advanced clinic access principles, collecting, and updating demographic and insurance information, patient processing, customer service, processing enrollment, benefits, eligibility and death benefits, and managing the NEAR list (New Enrollee Application Request).

Duties

Major Duties: Works collaboratively in an interdisciplinary coordinated care delivery model and performs receptionist duties, customer service and other duties assigned for the proper and timely treatment access to care for patients. Coordinates administrative services for Veterans, family members, caregivers, and public, administrative, and clinical staff to ensure continuity of inpatient and outpatient care. Interprets and applies a complex body of pertinent laws, regulations, directives, and policies that relate to the administration of VA healthcare benefits. Must have the knowledge to assume the role of a Transportation Specialist or Medical Support Assistant (MSA) during special projects or heavy workload, for leave, vacancies, or when the Transportation Specialist are detailed to fill-in other areas. Conducts special audits, studies, or surveys to be utilized in the development of procedures, and to assist in collecting complete and appropriate data for reporting processes and for generating revenue. Responsible for accurate appointment management and the coordination of all administrative information between the professional staff and the patient. Updating and verifying demographic information, scheduling appointments, collecting insurance information, data entry, and notifying the patient of their new patient scheduled appointment. Must have knowledge of clinic procedures and regulations; basic medical terminology, skill in operating computer systems and applications, such as VISTA, ESR, BTSSS, CPRS, and Microsoft applications to accurately enter or extract information. Participates in the daily team huddles and weekly/monthly team meetings where administrative planning and management occur, except during staff shortages for coverage. Must acquire knowledge of internal organizational procedures, knowledge of various facility services, knowledge of commonly used medical terminology and abbreviations, and VA acronyms and their meaning. Understand how to identify a Joint Commission surveyor and be able to articulate answers to questions they may be asked. Must screen/receive phone calls in a courteous and timely manner, determine the nature of requests and provide the information desired using privacy rules and established clinic processes. Performs work involving the collection, compilation, and/or tracking of data and statistical information in support of the organization's enrollment/eligibility program and admissions/acute care process utilizing Veterans Administration (VA), Veterans Benefits Administration (VBA) and Department of Defense (DOD) guidelines. Serves as technical advisor and liaison with contacts at all levels. Work requires the ability to work in a busy environment, multi-task, lead. Responsible for entering demographic information, insurance, military service data, eligibility status/verification and income information into the VISTA system, Enrollment System, and Insurance Capture Buffer. Assist in the triage of Catastrophic Disability ratings requests from patients, Social Worker's, and Clinicians in which the Veteran may qualify for and communicate requests including all pertinent information to the Health Benefits Unit Supervisor for consult placement. Identifies and collates health insurance information from all applicants for entry to VISTA and Insurance Capture Buffer, copies or scans insurance company enrollment identification cards, research employers as needed to obtain complete data when applicants do not have complete information; participates in the daily team let huddles and weekly team meetings where patient care planning and management occur, except during staff shortages for coverage. Reports may include but are not limited to the Inconsistencies report, Admission Review report, Inpatient Roster, Pending Disposition, Pending Verification, and the New Enrollee Appointment Request (NEAR). Responsible for scanning all pertinent documentation for eligibility and identity into the applicants Medical Record File in CPRS. Ensuring the documents have full name and SSN on it and scanning under the correct date of document, Type of Document, Description of document and correct patient record. Generates veteran ID cards through the Identity Management Toolkit for proofing identity and the Veterans Health Identification Card (VHIC) System, monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs as mandated by law. All other duties as assigned and detailed in Functional Statements Work Schedule: TBD Telework: Not Available Virtual: This is not a virtual position. Functional Statement #:04553F Relocation/Recruitment Incentives: Not Authorized 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, 06/25/2024 Basic Requirements: a. Citizenship. Citizen of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.g.) b. Experience and Education. (1) Experience. Six months experience of clerical, office, [customer service], or other [administrative] work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR, (2) Education. One year above high school; OR, (3) Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. 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: Customer Service, Call Center Experience, and Scheduling Experience. 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 the 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: See VA Directive and Handbook 5019.

Education

There is no education substitution at this grade level.

Contacts

• Address Las Vegas VA Medical Center 6900 North Pecos Road North Las Vegas, NV 89086 US
• Name: Tina Yang
• Phone: (415) 221-4810
• Email: [email protected]