Summary The Health Benefits Assistant determines eligibility and entitlement of VA Healthcare benefits. The incumbent serves in multifaceted capacity performing administrative duties relating to Eligibility, Admission, Reception, Beneficiary Travel, Patient Funds, and lodging of patients. Responsibilities This position is located in the Business Office Service Line at the Alvin C. York campus. Duties include but are not limited to: Corresponds with applicants relative to their application for care utilizing approved letters with requests for additional required information and proof of military service. Obtains all key information needed, including but not limited to, complete and accurate demographic information, health insurance information, worker's compensation information, etc. Ensures appropriate insurance information is obtained from veterans during the interview process and prior to any scheduled procedures for appointments in order to verify pre admission certification. Ability to input application information into the VISTA system and obtains all information required for patient processing. Ensures that appropriate personnel are notified when veterans are discovered to be ineligible for care. Knowledgeable of Public Law 104-262, the Veteran's Health Care Eligibility Reform Act of 1996 as it relates to patient care and serves as a subject matter expert and advisor to veterans on the National Enrollment Program, the established priority levels, the Uniform Benefits Package including but not limited to maternity care, emergency services, benefits not affected by this legislation, etc. Ability to fully understands all eligibility's in order to make initial determinations whether veterans/or non-veterans meet legal/contractual requirements for medical care. Required to make determinations as to which veterans are placed in certain categories based on complex and complicated income information and statements. Protects printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA policy. Protects data from unauthorized release or from loss, alteration, or unauthorized deletion. Follows applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in the computer access agreement that the employee signs. Ability to exercise good judgment in determining appropriate categories for veterans in relation to means test activities. Ability to meet the needs of customers while supporting VA missions. Consistently communicates and treats customers (veterans, their-representatives, visitors, and all VA staff) in a courteous, tactful, and respectful manner. Ability to provide the customer with consistent information according to established policies, and procedures. Handles conflict and problems in dealing with the customer constructively and appropriately. Work Schedule: 7:30 a.m. - 4:00 p.m. Monday - Friday Telework: Not Available Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Assistant (OA)/PD70213A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required Physical Requirements: The work is sedentary. Typically, the employee sits comfortably to do the work. However, there may be some walking; standing; bending; carrying of light items such as papers, books, small parts; or driving an automobile, etc. No special physical demands are required to perform the work. Requirements Conditions of Employment Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/28/2024. Typing Proficiency Requirements: This position requires a Typing Proficiency. To qualify for the position applicants must be able to type 40 words per minute typing speed. Applicants may meet these requirements by passing the appropriate performance test, presenting a certificate of proficiency from a school or other organization authorized to issue such certificates by the Office of Personnel Management local office, or by self-certifying their proficiency. In addition to meeting the Typing Proficiency above, candidates must meet the following specialized experience requirement. You may qualify based on your experience and/or education as described below: GS-5 SPECIALIZED EXPERIENCE: Do you possess one (1) full year of specialized experience in the Federal service equivalent to at least the next lower grade in the normal line of progression for the occupation in the organization. Specialized experience is defined as: Interpretation of pertinent eligibility and enrollment laws, regulations, policies, guidelines, and procedures to determine veterans eligibility for care: input data from documents into appropriate database; provide financial guidance to applicants based on means and co-pay test; and explain eligibility information to applicant. Utilize databases to review documentation and history; develops organizational and interdepartmental relationship to facilitate the exchange of information. Provide exceptional customer service; Initiates registration process, enters a means test, and updates demographics; provides claims development for eligibility requests; demonstrated knowledge in the use of computers, such as typing, powering on and off, connecting to the internet, navigates to and within operating system applications. Effectively communicates verbally and in writing with a variety of people from different backgrounds and different levels of understanding in order to respond to questions and inquiries in written correspondence and face-to-face with veterans. 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 above high school (Transcript Required). OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond 4 years above high school (Transcript Required). You will be rated on the following Competencies for this position: Information Management Interpersonal Skills Organizational Stewardship Veteran and Customer Focus 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. 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. Additional Information Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This job opportunity announcement may be used to fill additional vacancies. As required by Executive Order 14043, Federal employees are required to be fully vaccinated against COVID-19 regardless of the employee's duty location or work arrangement (e.g., telework, remote work, etc.), subject to such exceptions as required by law. 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 exception from this requirement using the reasonable accommodation process. Due to COVID-19, VA is currently in an expanded telework posture. If selected, you may be expected to temporarily telework, even if your home is located outside the local commuting area. Once employees are permitted to return to the office, you will be expected to report to the duty station listed on this announcement. Management officials will provide information about returning to the official, pre-pandemic worksite, when applicable. At that time, you may be eligible to request to continue to telework depending upon the terms of your organization's telework policy and the duties of the position. If you are unable to apply online view the following link for information regarding an Alternate Application.