Claims Assistant

Summary

The Claims Assistant works as part of the Benefits and Enrollment Section of the Business Office within the Iowa City VA Health Care System (ICVAHCS). The incumbent's primary duties are to help Veterans determine eligibility and entitlement for health care services in the VA system. This can include, but may not be limited to inpatient and outpatient medical care, dental care, ophthalmology, home oxygen and prosthetics.

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Overview

• Accepting applications

• Open & closing dates

09/25/2024 to 10/03/2024

• Salary

$39,576 - $51,446 per year

• Pay scale & grade

GS 5

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Location

1 vacancy in the following location:

• Iowa City, IA

• Remote job

No

• Telework eligible

No

• Travel Required

Not required

• Relocation expenses reimbursed

No

• Appointment type

Permanent

• Work schedule

Full-time

• Service

Competitive

• Promotion potential

None

• Job family (Series)

• 0998 Claims Assistance And Examining

• Supervisory status

No

• Security clearance

Not Required

• Drug test

No

• Position sensitivity and risk

Non-sensitive (NS)/Low Risk

• Trust determination process

• Credentialing

• Suitability/Fitness

• Financial disclosure

No

• Bargaining unit status

Yes

• AFGE/ 1272

• Announcement number

CBSY-12558516-24-LCS

• Control number

811316400

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This job is open to

• Career transition (CTAP, ICTAP, RPL)

Federal employees who meet the definition of a "surplus" or "displaced" employee.

• Federal employees

• Competitive service

Current or former competitive service federal employees.

• Federal employees

• Excepted service

Current excepted service federal employees.

• Individuals with disabilities

• Internal to an agency

Current federal employees of this agency.

• Land & base management

Certain current or former term or temporary federal employees of a land or base management agency.

• Military spouses

• Peace Corps & AmeriCorps Vista

• Veterans

Clarification from the agency

Current permanent Veterans Canteen Service employees may apply for consideration under this vacancy announcement. By law, Veterans Employment Opportunity Act (VEOA) applicants may apply for consideration under this vacancy announcement who are (a) preference eligibles, or (b) Veterans whose most recent military separation was under honorable conditions after substantially completing at least 3 years of continuous active military service.

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Duties

Major Duties listed but not limited to:

• Interviews and counsels Veterans applying for outpatient and inpatient medical care as determined by Public Laws 99-272 and 100-332 and other VA Handbooks, Manuals and /or Directives

• Assists veterans in gathering information consulting with or using Hospital Inquiry (HINQ) or Veteran Information System (VIS), State Bonus Boards, VA Regional offices, Health Eligibility Center (HEC), county veteran affairs offices, service organizations, and county court houses

• Assists veterans with completion of the means test (financial assessment) process by answering veteran's questions and utilizing interview techniques to assist them in completing the means test

• Obtains completed and signed application and means test when applicable prior to medical services being provided

• Maintains procedural consistency by completing entry of applications and means test information in a timely manner, expediting some due to medical need or as specified by supervisor

• Advises and assists individuals applying for special programs, i.e. Agent Orange/Nuclear Weapons/Persian Gulf programs/examination, CHAMPVA (Civilian Health and Medical Program of Iowa), Purple Heart, Veterans Choice Act, and other benefits through VA Regional Offices

• Screens applicants for humanitarian emergencies, possible third party and workmen's compensation cases

• Provides updates on veteran pre-registration data after viewing valid identification (ID) with picture or other appropriate form of ID that matches Veterans Integrated System Technical Architecture (VISTA) documentation

• Processes admissions accurately and timely, determining bed availability according to policy and entering required information into VISTA

Work Schedule: Monday

• Friday: 7:30am- 4:00pm

Virtual: This is not a virtual position.

Position Description/PD#: Claims Assistant/PD50358A

Relocation/Recruitment Incentives: Not Authorized

Critical Skills Incentive (CSI): Not Authorized

Permanent Change of Station (PCS): Not Authorized

Financial Disclosure Report: Not required

The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

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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, 10/03/2024.

You may qualify based on your experience and/or education as described below:

• Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Specialized experience includes but is not limited to: Guiding patients while adhering to various regulations; assist patients with processing documents; work with patients to resolve concerns; interpret documents and notes related to the claims process; and records maintenance through hard copy or electronic means. 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 of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite is creditable at grades GS-3 through GS-5 for all positions. (TRANSCIPTS REQUIRED). OR,
• Combination: Applicants may also combine education and experience to qualify at this level. In order to be considered creditable, you must have the equivalent combination of post-secondary education and experience that meets the GS-5 experience requirements. (TRANSCIPTS REQUIRED)

The following are examples of how education and experience may be combined. They are examples only, and are not all inclusive:

The position to be filled is an Editorial Assistant, GS-5. The applicant has 9 months of specialized experience and 75 semester hours of college (15 semester hours beyond the second year and the equivalent of 3 months of specialized experience). The applicant meets 75 percent of the required experience and 25 percent of the required education. The applicant meets 100 percent of the requirement for 1 year of specialized experience and is qualified for the position.

You will be rated on the following Competencies for this position:

• Communications

• Customer Service (Clerical/Technical)

• Manages and Organizes Information

• 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: You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of evaluation or examination.

Work Environment: The work is normally performed in an office setting. The work area typically is adequately lighted, heated and ventilated.

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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Additional information

Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator.

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.

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 (TJO). Please visit the Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP), va.gov/EMPLOYEE/docs/The-Fair-Chance-to-Compete-Act.pdf for more information.

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• Benefits

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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new window

Learn more about federal benefits.

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

Narrative responses are not required at this time. If you are referred for consideration, you may be asked to submit additional job related information, which may include, but not limited to; responses to the knowledge, skills and abilities; completion of a work sample, and/or contact for an interview. Your resume and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document.

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.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.