The incumbent serves as a Lead Program Support Assistant for the Health Benefits Center within the Syracuse VA Business Office located at the Syracuse VA Medical Center and performs a broad range of administrative activities in support of an integrated business unit that administers health and related benefits within an integrated system of VA health care resources and health care access points.

Duties

Leading a team of employees that provide Veterans' eligibility determinations, financial technician functions, basic Medical Cost Care Fund functions, transportation functions, beneficiary travel billing management, health benefit determination and counseling, subject matter expert and educator/trainer for VSC staff. Provide accurate, timely information in a courteous manner to veterans, their family members, Veterans Service Organizations, Medical Center staff, associated stakeholders, and the general public. Patient Enrollment, Eligibility Verification, Means Test, Veterans Identification Cards, Valor Inn, Decedent Affairs, Dental Eligibility, Fugitive Felon Program, Hardships, Master Patient Index, Patient Financial Services, Pre-Registration, VIC Cards and Beneficiary Travel. Maintain a thorough working knowledge and understanding of principles, concepts, policies, laws, regulations, and objectives applicable to an extensive variety of multiple complex and interacting VA and benefit programs including but not limited to eligibility determination, health benefit counseling, financial assessment processes, co-payment responsibilities, Beneficiary Travel, Long Term Care eligibility, Non-VA Care, Sharing Agreements such as TRICARE and CHAMPVA. Advise applicants of the health care benefits they are legally entitled to, initiate administrative processes for establishing care, and notify appropriate healthcare personnel accordingly. Answers multiple inquiries and educates employees, veterans, families, and internal and external stakeholders. Respond to complex questions involving regulations and/or beneficiary entitlements and will handle or disposition concerns ensuring that quality service is rendered in a timely, complete and caring manner. Keep abreast of the frequent changes in laws, regulations and/or other pertinent directives that change medical benefits and entitlements. Respond to technical questions regarding a patient's administrative rights and situational eligibility for healthcare and provide patients with needed administrative advice and guidance. Advise veterans on non-medical benefits and refers to area Benefits Counselor's for claims as appropriate. Research situations where the eligibility of applicant cannot be immediately established. Educate and counsel veterans, families, and. agency employees regarding veteran entitlement to healthcare benefits. When called upon, clarify inpatient and outpatient policies for patients, families, agency employees, and veterans' organizations. Receive, review, and process new and recurring applications for Medical, Dental, Behavioral Health, Geriatrics and Extended Care, Diagnostic and Therapeutics, outpatient, inpatient, and Long Term Care services, independently applying the appropriate unique regulatory authority to each program. May be required to process inpatient hospital admissions including medical, surgical, behavioral health, domiciliary, and/or nursing home. Independently verify eligibility for care utilizing primary sources including but not limited to HINQ, VIS, and/or military discharge papers. When it is determined the applicant is ineligible for VHA health benefits, the incumbent will provide a comprehensive explanation of denial, offers alternative healthcare resources, explains the appeals process, and/or refers applicant to a specialized advisor. Other duties as assigned. Work Schedule: Monday - Friday 8:00am - 4:30pm Telework: Ad-Hoc Virtual: This is not a virtual position. Position Description/PD#: Lead Program Support Assistant/PD01086O

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/24/2024. 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-7 position you must have served 52 weeks at the GS-6. 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 as described below: Specialized Experience: In order to qualify for this position you must have one year of specialized experience (equivalent to the GS-06 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization. Specialized experience includes but is not limited to extensive knowledge with matters pertaining to the administrative aspects of patient care and Veteran medical benefits. Incumbent must have expert knowledge of all regulations, directives, policies and procedures governing all VSC programs. VSC programs include: Enrollment and Registration, Eligibility determination, Bed Control/Emergency Room, Descendent Affairs, Beneficiary Travel, PFOP, Billing, Hotel, Environmental Exposure Program, Sharing Agreements such as TRICARE/Champ VA, and Data Integrity. Must have a working understanding of priorities and be able to work under considerable pressure, plan work without halting or interrupting the operation as a whole by showing initiative in completing priority tasks. Incumbent must be able to assess workload at any given time and assist all VSC staff and/or redistribute workload. Knowledge of the Privacy Act and Freedom of Information Act. The incumbent must have the ability to refer inquiries or situations pertaining to any element within his/her jurisdiction to a manual or other VA reference to produce an acceptable resolution. Knowledge and ability to locate, extract, and present information in clear and effective language so decisions may be made to best achieve facility goals. Able to provide accurate information to management, employees and patients regarding Veteran benefits such as: applications and/or admissions to inpatient and/or outpatient status, nursing home care, and beneficiary travel benefits. Must be competent in determining eligibility pertaining to inpatient and outpatient care, death benefits, non-VA treatment, beneficiary travel benefits, etc. Knowledge to assess documentation for accuracy, ability to review data with supervisor, skill in determining corrective actions, competent in developing monitors and an effective communicator. You will be rated on the following Competencies for this position: Computer SkillsCustomer Service (Clerical/Technical)FlexibilityProblem 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: The work involves walking, bending, and lifting of medical records and working at a PC. The incumbent may come in contact with angry and potentially violent customers. Position requires a high level of concentration. 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

There is no educational substitution at this grade level.

Contacts

• Address Syracuse VA Medical Center 800 Irving Ave Syracuse, NY 13210 US
• Name: Stephen Jones
• Phone: 315-425-3791
• Email: [email protected]