Location: Binghamton,NY, USA
Summary The Health Benefits Center is looking to fill 1 vacancy for a PSA, they perform but not limited to a broad range of administrative activities in support to community outreach activities, eligibility determination, program management, financial technician functions, basic Medical Cost Care Fund functions, transportation functions, beneficiary travel billing management, health benefit determination and counseling, data management, Sharing Agreements, etc. Responsibilities Major duties include but are not limited to: Advise applicants of the health care benefits they are legally entitled to. Initiate administrative processes for establishing care, and notify appropriate healthcare personnel accordingly. The incumbent is required to keep abreast of the frequent changes in laws, regulations and/or other pertinent directives that change medical benefits and entitlements. Educate and counsel veterans, families, and agency employees regarding veteran entitlement to healthcare benefits. Receives, reviews, and processes new recurring applications for Medical, Dental, Behavioral Health, Geriatrics and Extending Care, Diagnostic and Therapeutics, inpatient, outpatient, and Long-Term Care services. Verify eligibility for care utilizing primary sources including but not limited to HINQ, VIS, and/ or military discharge papers. The incumbent will educate Medical Center and CBOC staff about patient benefits specific to each sharing agreement to facilitate appropriate and timely delivery of health care services within the scope of the agreement. Responsibilities include financial data collection, data entry, analysis, and interpretation of initial and subsequent annual veteran financial assessments. Prepare Means Test reminder letters; provide the National Health Eligibility Center with current authenticated financial assessments; monitor, trend status of incomplete means tests providing follow-up activities when required. Provide veterans with billing information and serve as primary contact for billing issues; includes research, identification, analysis, and resolution/reconciliation utilizing the VISTA billing software to research individual billing information. Determine eligibility for travel at government expense, based upon applicable federal regulations and policies. Work Schedule: M-F 8:00am - 4:30pm Virtual: This is not a virtual position. Position Description/PD#: Program Support Assistant/PD01040A Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See Additional Information below for details. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/06/2024. 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-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. 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: 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: Have at least one (1) full year of specialized experience equivalent to the GS-5 level in the Federal service that equipped me with the knowledge, skills, and abilities to successfully perform the duties of the position, and that is typically in or related to the work of the Program Support Assistant position. Specialized experience includes but are not limited to. Must maintain a thorough working knowledge and understandings 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. Must possess thorough knowledge and understanding of VA Health benefits available to beneficiaries of the DOD, CHAMPVA, and TRICARE programs; including working knowledge of applicable laws, regulations, policies governing VA treatment of DOD members; and proficient in communicating benefit information to patients' population. Provides Veterans with billing information and serve as primary contact for billing issues; includes research, identification, analysis, and resolution/reconciliation utilizing VISTA billing software to research billing information; coordinates communications with Medical Care Cost Funds (MCCF) and pharmacy staff; and provide appropriate follow through to ensure billing issues are resolved. Must demonstrate working knowledge and technical proficiency in administration of multiple Beneficiary Travel programs; eligibility criteria and regulatory authorities for each; to appropriately administer the program benefits to eligible veterans. Demonstrate advance knowledge in scheduling and coordinating patient transportation and must demonstrate knowledge in Personal Funds of Patients Program. You will be rated on the following Competencies for this position: Computer Skills Customer Service (Clerical/Technical) Interpersonal Skills Problem 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 is primarily sedentary, although some slight physical effort may be required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at Education There is no educational substitution at this grade level. 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: 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: Additional Information This job opportunity announcement may be used to fill additional vacancies. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.