The Claims Assistant works as part of the Benefits and Enrollment Section of the Business Office within the Iowa City VA Health Care System (ICVAHCS). The incumbent's primary duties are to help Veterans determine eligibility and entitlement for health care services in the VA system. This can include, but may not be limited to inpatient and outpatient medical care, dental care, ophthalmology, home oxygen and prosthetics.

Duties

Major Duties listed but not limited to: Interviews and counsels Veterans applying for outpatient and inpatient medical care as determined by Public Laws 99-272 and 100-332 and other VA Handbooks, Manuals and /or Directives Assists veterans in gathering information consulting with or using Hospital Inquiry (HINQ) or Veteran Information System (VIS), State Bonus Boards, VA Regional offices, Health Eligibility Center (HEC), county veteran affairs offices, service organizations, and county court houses Assists veterans with completion of the means test (financial assessment) process by answering veteran's questions and utilizing interview techniques to assist them in completing the means test Obtains completed and signed application and means test when applicable prior to medical services being provided Maintains procedural consistency by completing entry of applications and means test information in a timely manner, expediting some due to medical need or as specified by supervisor Advises and assists individuals applying for special programs, i.e. Agent Orange/Nuclear Weapons/Persian Gulf programs/examination, CHAMPVA (Civilian Health and Medical Program of Iowa), Purple Heart, Veterans Choice Act, and other benefits through VA Regional Offices Screens applicants for humanitarian emergencies, possible third party and workmen's compensation cases Provides updates on veteran pre-registration data after viewing valid identification (ID) with picture or other appropriate form of ID that matches Veterans Integrated System Technical Architecture (VISTA) documentation Processes admissions accurately and timely, determining bed availability according to policy and entering required information into VISTA Work Schedule: Monday - Friday: 7:30am- 4:00pm Virtual: This is not a virtual position. Position Description/PD#: Claims Assistant/PD50358A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/03/2024. 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-04 in the normal line of progression for the occupation in the organization. Specialized experience includes but is not limited to: Guiding patients while adhering to various regulations; assist patients with processing documents; work with patients to resolve concerns; interpret documents and notes related to the claims process; and records maintenance through hard copy or electronic means. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5 for all positions. (TRANSCIPTS REQUIRED). OR, Combination: Applicants may also combine education and experience to qualify at this level. In order to be considered creditable, you must have the equivalent combination of post-secondary education and experience that meets the GS-5 experience requirements. (TRANSCIPTS REQUIRED) The following are examples of how education and experience may be combined. They are examples only, and are not all inclusive: The position to be filled is an Editorial Assistant, GS-5. The applicant has 9 months of specialized experience and 75 semester hours of college (15 semester hours beyond the second year and the equivalent of 3 months of specialized experience). The applicant meets 75 percent of the required experience and 25 percent of the required education. The applicant meets 100 percent of the requirement for 1 year of specialized experience and is qualified for the position. You will be rated on the following Competencies for this position: CommunicationsCustomer Service (Clerical/Technical)Manages and Organizes InformationProblem Solving 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: You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of evaluation or examination. Work Environment: The work is normally performed in an office setting. The work area typically is adequately lighted, heated and ventilated. 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

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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Iowa City VA Health Care System 601 Highway 6 West Iowa City, IA 52246 US
• Name: Luther Smith Jr.
• Phone: 612-467-6901
• Email: [email protected]