The incumbent serves as the Lead AMSA for Enrollment & Eligibility Department within PAS. The incumbents working knowledge of various policies and procedures relating to the business rules regarding the enrollment processes and procedures, as well as the multiple electronic systems and software programs utilized within the team to ensure the proper flow of work within the team. The ideal candidate will have 1 year of experience using eligibility policy, processes and systems.

Duties

Major Duties: Experience using eligibility policy, processes and systems. Provides educational sessions to train new employees in Clerical process in an efficient and effective manner to ensure that clerical processes, functions, and goals are understood and met. Must have knowledge of VA policies, regulations, guidelines, and process as they relate to the scheduling of patient appointments, consults, NEAR, Electronic Wait Lists, and pre-appointment clinical requirements (i.e., labs, EKGs, x-rays) to ensure readiness for the patient visit. Monitors clinic's Access to care. Monitors ICB usage ensuring insurance is collected and captured appropriately at enrollment. Must keep abreast of rapidly changing regulations, directives, software patches, programs, and processes involved in the delivery of the healthcare benefits package. Assist with the clean-up of the EARR (Encounter Action Required Report) and delinquent recall report; support clinics regarding utilization and clinic profile management i.e., set-up of clinic grids, cancel and restore clinics. Screens/receive phone calls in a courteous and timely manner, determine the nature of request and provide the information desired using privacy rules and established clinic processes. Prepares correspondence and memos as needed. Promotes Veteran registration for and utilization of My Healthy Vet (MHV). Enters Veterans seeking emergent/urgent care, scheduling appointments accurately. Utilizes call lists and telephones Veterans to pre-register them before their scheduled visits. Incumbent updates all patient demographics. 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. Assures that all appropriate VA forms are used correctly, and regulations followed. The incumbent oversees the status of work for all lower grade MSA positions working in the various clinical services making day-to-day adjustments in accordance with established priorities, obtaining assistance from the supervisor on problems that may arise, such as backlogs which cannot be disposed of promptly. Able to resolve workplace issues, simple informational complaints of employees, referring other to supervisor for resolution. Incumbent will conduct ongoing audits to ensure quality of work for accurate and timely scheduling of appointments. Recognizes and refers substandard performance or substandard behavior to supervisor as needed. Provides information and/or makes recommendations to supervisor on MSA performance, behavior. Identifies education and training needs of staff and evaluating scheduling practices. Makes recommendation for reassignments, recognition for outstanding performance and other personnel needs. Orienting and providing on the job training for new and current employees. As a front-line contact with patients and staff, in the scheduling role, the incumbent sets the tone for perception concerning quality of healthcare services at the VA and will show a high degree of tact and diplomacy when dealing with Veterans who have multiple health problems and who may be frustrated with the administrative process associated with diagnosis and treatment. The incumbent supports patient safety standards using appropriate standards of identification. validation i.e., two forms of identification, name, and full Social Security Number. The incumbent must ensure preregistration is completed and collects, scans, and updates health insurance information serving a major role in the revenue process. Will also possess superb telephone etiquette utilizing the standardized telephone greeting while ensuring other frontline staff is as well. This incumbent must have the ability to learn the technical competency in the use of BMS, VistA, VSE, CPRS, ICB Scanners, Vet-link, Kiosks, HIN, VAR and MHV. Must provide excellent customer service and have an advanced understanding of medical terminology, medical administrative practices, patient consult processes, patient scheduling procedures, medical record system, Privacy Act, HIPP A rules and the Freedom Act as they relate to the handling of confidential and sensitive patient information. Incumbent must be a proficient computer operator who is able to learn, understand, and monitor department specific software programs. Must also be knowledgeable in Microsoft Office programs such as Word, Excel, PowerPoint, and Outlook; proficient in gathering, analyzing, and reporting data as it relates to inpatient units and outpatient clinic operations. Work Schedule: Monday-Friday 8:00am - 4:30pm Telework: Not Suitable Virtual: This is not a virtual position. Functional Statement #: 578-00056-F Relocation/Recruitment Incentives: Not Authorized. Financial Disclosure Report: Not required.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements on the closing date of this announcement. The ideal candidate will have 1 year of experience using eligibility policy, processes and systems. Incumbent must possess knowledge of clinic processes and service in order to interact with various clinic staff members. This employee must have working understanding of national performance measures and monitors, particularly in relation to no-shows, appointment cancellations, new patient scheduling, consult management and management of returning patients. Maintains current knowledge of procedures, policies, guidelines, etc. to be able to answer questions or obtain needed information to make an informed decision. Incumbent complies with all mandatory requirements regarding the scheduling process in order to maintain scheduling access. BASIC REQUIREMENTS: Citizenship: Must be a United States Citizen. Language: Must be proficient in basic written and spoken English. EDUCATION/EXPERIENCE: Must possess six (6) months experience of clerical, office, customer service or other administrative work that indicates the ability to acquire the knowledge and skill necessary to perform the duties of the Medical Support Assistant. OR Must have successfully completed one (1) year above high school. This education must have been obtained in an accredited technical school, junior college, college, or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university. OR Equivalent combinations of experience and education are qualifying for entry level. IN ADDITION TO MEETING THE BASIC REQUIREMENTS LISTED ABOVE, YOU MUST MEET THE GRADE REQUIREMENTS AT THE GS-7 LEVEL TO QUALIFY FOR THIS POSITION. GS-7 LEVEL GRADE REQUIREMENTS: Must have one (1) year of experience that is directly related to the duties of a MSA and that equips you with the knowledge, skills, and abilities to successfully perform the duties of this position. To be creditable, this experience must be equivalent to the next lower grade level, GS-6 and demonstrate the knowledge, skills, and abilities associated with current MSA responsibilities. Experience at this level includes but is not limited to: Experience using eligibility policy, processes and systems. Providing specialized and expert administrative patient support while working collaboratively in an interdisciplinary coordinated care delivery model. Work involves specialized administrative judgment and the flexible use of a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or care in the community resources. Recommending changes to existing clinic procedures based on current administrative guidelines. Expertise in utilizing numerous advanced patient systems in support of multiple clinics involved in an interdisciplinary coordinated care delivery model. Coordinating with the patient care team to review clinic appointment availability utilization to ensure that clinic schedules are closely monitored to effectively support the needs of the clinics and adjusting as necessary. Maintaining effective and efficient communication with the patient, interdisciplinary coordinated care delivery model teams, VA medical centers, and other agencies (e.g., assist with communications during the inpatient to outpatient discharge; communicate with non-VA medical facilities. Preparing correspondence to notify patients of normal lab results. Managing a system for follow-up care such as consults, tests, etc.). Processing incoming patient secure messaging through MyHealthyVet and coordinating with care team as appropriate. Participating in team huddles and team meetings to manage, plan, problem solve, and follow-up with patient care by sharing information and collaborating with the interdisciplinary team. Setting priorities and deadlines, adjusting the flow and sequencing of the work to meet team and patient needs. Identifying incomplete encounters and communicates findings to providers. Assisting the team to reinforce the plan of care and self-help solutions. Entering appropriate information into the electronic record. Monitoring pre-appointment information and/or requirements to assure readiness for patient visit/procedure. Managing patient systems to verify and validate accuracy and resolve issues. Evaluating patient information and clinic schedule lists to determine whether the patient requires an immediate appointment. Informing team members about shared patients. You also must demonstrate the following Knowledge, Skills and Abilities (KSA's): Advanced knowledge of medical terminology and a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or community resources. Ability to utilize numerous advanced patient systems in support of multiple clinics in an interdisciplinary setting Ability to organize work, set priorities, and delegate tasks/responsibilities in order to meet deadlines. Skill in communicating with individuals to obtain the desired effect [and coordinating with a variety of interdisciplinary care team staff. Ability to provide staff development and training. Ability to manage staffing requirements, manage workflow priorities, and adjust the flow of work to meet team and patient needs. This includes the ability to follow-up on pending issues and demonstrate an understanding of the impact of incomplete work across multiple clinics. References: VA Handbook 5005/117, Part II, Appendix G45, Medical Support Assistant Qualification Standards. This can be found in the local Human Resources Office. The full performance level of this vacancy is GS-07. Physical Requirements: The work is primarily sedentary. Physical demands do not exceed those of a typical office setting. There may be some walking, standing twisting, turning, sitting, pushing, bending, repetitive keyboarding, or carrying of light items. Some positions may require sitting for long periods of time at a computer terminal typing data while talking on a telephone headset.

Education

There is no educational substitution at this grade level.

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your basic requirements on education.

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 Edward Hines Junior Hospital 5000 South 5th Avenue Hines, IL 60141 US
• Name: Michael Simmons - HINES
• Phone: 515-217-2774
• Email: [email protected]