The Advanced MSA works collaboratively in an interdisciplinary coordinated care delivery model and assists the clinical providers in coordinating certain administrative details, appointment schedules and clinic consult services; customer service and other duties assigned for the proper and timely treatment of patients and maintain appointment schedules for the Jackson CBOC.

Duties

The Advanced Level Medical Support Assistant (MSA) position serves as a Consult Coordinator and is a foundational role within the continuum of patient care. The MSA works collaboratively with other members of expanded health care teams (i.e., PACT, specialty care) including Community Care providers, pharmacists, social workers, dieticians, behavioral health staff, etc. to provide a robust interdisciplinary approach to care. Important interfaces and collaborations also occur with larger health care system providers including VA and non-VA specialists, hospitals, diagnostic and treating facilities, and community-based programs. Explains the VA's mandate to collect insurance information to veterans, their families, and other eligible patients. Promotes veteran registration for and utilization of My HealtheVet (MHV). The Advanced MSA may also be required to train other MSA levels on the Community Care process. As first line contact with patients and staff, the incumbent sets the tone for perception concerning quality of healthcare services at the VA. A high degree of tact and diplomacy is required when dealing with veterans who have multiple health problems and who may be frustrated with the administrative process associated with diagnosis and treatment. This position is responsible for generating authorizations for pre-authorized outpatient, unauthorized and emergency care claims, while making eligibility determinations for the various programs in Community Medical Care. Required fund of knowledge for generation of authorizations is multi-faceted in that incumbent must generate authorizations across several systems: the Veterans Health Information Systems and Technology Architecture (VistA), the Fee Basis Claim System (FBCS), Computerized Patient Record System (CPRS) and Health Share Referral Manager (HSRM). Works closely with utilization review to ensure proper authorizations are issued and appropriate correspondence is sent to vendors. He/she acts as a liaison between the veteran and the vendors regarding Community Medical Care section and VA clinical services and/or primary care services. Incumbent utilizes FBCS and VistA to manage and coordinate appointment management with the creation of authorizations as outlined by the Community Care Coordination National SOPs. Works to resolve issues with veterans, vendors and clinical staff to ensure appropriate care is scheduled and authorized at Community Care facilities. Additional duties or tasks may be assigned by the supervisor to ensure efficient daily operations. Collaborates with VA clinicians, third party administrator (TPA) and community clinicians to obtain clinical documentation and direction to further coordinate, plan, organize, and direct outpatient/inpatient community care and complex outpatient/inpatient diagnostic procedures. Coordinates follow-up care at the direction of the community clinicians/vendor, TPA and the VA clinicians including providing evaluation and diagnostic reports to VA clinicians for continuation of care and verification of care authorized. The incumbent contacts clinicians, hospitals, pharmacies, Veterans and their accredited representatives to obtain supportive information for authorization of care, i.e., CPT codes, vendor information, additional clinical information, clinical requirements. The incumbent research problem cases and rejected payments often using ingenuity and foresight in their resolution. He/she must be aware of all possibilities beyond their control where errors in keypunching, transmittal, calculations, or transposing of figures may have occurred, and must be able to trace the error and resolve the discrepancy. He/she must be able to read and interpret data and utilize information in performance of duties. The incumbent can retrieve, view, and process Secondary Authorization Requests (SARs) and send them to the appropriate approving authority for disposition. Meets the needs of customers while supporting the Medical Center and Service missions. Consistently communicates and treats customers (patients, visitors, volunteers, and all Medical Center staff) in a courteous, tactful, and respectful manner. Provides the customer with consistent information according to established policies and procedures. Handles conflict and problems that may arise with caution and within established protocol to ensure the safety of self and others. Work Schedule: Monday - Friday 8:00am - 4:30pm Compressed/Flexible: Not Authorized Telework: May be approved on an ad-hoc basis Virtual: This is not a virtual position. Functional Statement #: 50404F Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the cut-off date of each applicant referral for this announcement. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency: MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.j. 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. Certification. None required. English Language Proficiency. MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, part II, chapter 3, section A, paragraph 3j. Foreign Education. To be creditable, education completed outside the U.S. must have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and such education must have been deemed at least equivalent to that gained in conventional U.S. programs. Grade Determinations: In addition to the basic requirements for employment listed above, the following education and experience criteria must be met when determining the grade of candidates: Medical Support Assistant (Advanced), GS-6: Experience. One year of experience equivalent to the GS-5 grade level. GS-5 grade level experience includes, but is not limited to, independently performing a full range of duties related to the delivery of healthcare services in an inpatient or outpatient setting: advises clinical staff on current administrative processes; responsible for answering phones, greeting patients, relaying messages to appropriate staff inside or outside the unit; scheduling appointments, including interpreting and verifying provider orders; canceling and re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources; verifying and updating demographics and insurance information; and, coordinating administrative functions relating to emergency and non-emergency transfers to other facilities. AND Demonstrated Knowledge, Skills, and Abilities. Candidates must demonstrate all of the KSAs below: 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. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. 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. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. 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. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. References: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-06. Note: You must provide detailed information of your experience performed. Information such as "I was a Medical Support Assistant" is insufficient to determine your qualifications. Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hour worked per week. Physical Requirements: Typically, the Advanced Medical Support Assistant must be able to operate a computer terminal and be able to manage multiple activities at one time. Work is generally sedentary; however, there may be some walking, standing, bending, and carrying of light items. Work Environment: The work may be stressful due to the accelerated pace for several hours at a time during peak clinic hours or on days that have a large volume of clinic activity. Work Environment: The work may be stressful due to the accelerated pace for several hours at a time during peak clinic hours or on days that have a large volume of clinic activity.

Education

There is no substitution of education for experience at this grade level.

Contacts

• Address Memphis VA Medical Center 1030 Jefferson Avenue Memphis, TN 38104 US
• Name: Charity Street
• Phone: 615-695-2157
• Email: [email protected]