The incumbent serves as a Program Support Assistant within the Revenue Operations (RO) Consolidated Patient Accounts Center (CPAC) Revenue Utilization Review (RUR) department. The CPAC is a regionally consolidated business line established to enhance revenue within the Veterans Health Administration (VHA) using an industry-best model built on regional management of key aspects of the revenue cycle, process standardization, accountability, and economies of scale.

Duties

Performs a broad range of duties to assist in achieving the RO/CPAC expected results for first and third party collections Make decisions/recommendations based on the development and evaluation from various sources. Make independent decisions in a wide variety of unique scenarios. Interpret payer review criteria to comply with various health plans and benefit languages. Adapt to continuing changes in program, technological developments and conflicting requirements. Use medical terminology to perform reviews of patient medical records for third party pre-certification process. Verify third party payer requirements for Veterans' insurance coverage. Respond appropriately to questions and inquiries from third party payers and internal customers. Exhibit flexibility and consideration when working with internal and external stakeholders. Reviews data analytics and metric expectations. Prioritize workload according to department need and leadership direction. Work Schedule: Monday - Friday, 0800am - 4:30pm Compressed/Flexible: May be available, pending agency needs Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Program Support Assistant/PD05206A 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 closing date of this announcement, 12/30/2024. 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 G-06 position you must have served 52 weeks at the GS-05. 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. You may qualify based on your experience as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: . 1) Interprets payer review criteria to comply with various health plans and benefit languages. 2) Verifies Third-Party Payer requirements for insurance coverage. 3) Uses various electronic processing programs, applications and computer systems to identify and resolve issues. 4) Applies government polices and regulations dealing with revenue. 5) Evaluates interrelated facts and selects the most appropriate principles and precedents for making an independent decision. Note: Evidence of specialized experience must be supported by detailed documentation of duties performed in positions held on your resume. You must provide work experience information such as hours per week, salary, and starting/ending dates of employment (month and year format) to establish you have one (1) full year of Specialized Experience at or comparable to the required grade level. You will be rated on the following Competencies for this position: Decision MakingInsuranceProblem SolvingTechnical Credibility 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 is primarily sedentary but may require some physical effort such as periods of standing, walking, sitting, or bending. This position requires visual acuity, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The incumbent must be an individual capable of working effectively in stressful situations and able to shift priorities based on organizational needs. 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 Western Consolidated Patient Accounts Center 1085 Palm Airport DR Las Vegas, NV 89119 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]