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Claims Assistant - Department of Veterans Affairs - Altoona, PA

Summary

About the Agency

OUR MISSION: To fulfill President Lincoln's promise: "To care for him who shall have borne the battle, and for his widow, and his orphan" - by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans?

The Department of Veterans Affairs (VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service. If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA. The VA is committed to hiring Veterans.

The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission.

The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families and other beneficiaries. The Values are Integrity, Commitment, Advocacy, Respect and Excellence ("I CARE"). America's Veterans need you!

Duties

This position is located in the Care Coordination Section of Health Administration Services. The employee is responsible for administering Care in the Community services (to include all services through the Non-VA Care/CHOICE Program/Veterans Choice Program Provider Agreements) to all eligible veterans, using nationally and locally defined processes and procedures to meet the needs of our veterans and the medical center This position provides administrative coordination of patient care and appointments as well as logistical factors associated with direct patient care, inpatient and outpatient, related to the coordination of care between Altoona VAMC and community providers. Major duties include but are not limited to:

• Screens new consults for community care for eligibility, specialty service requests, duplication and appropriateness of sending patient to community provider;
• Verifies eligibility for each of the community care programs to include outpatient, inpatient and emergency care;
• Reviews insurance, Veteran status and conditions related to service connection before administrative eligibility is verified;
• Provides community care technical assistance to Veterans, their beneficiaries and/or personal representatives regarding entitlement and guidelines for the authorization of treatment at VA expense;
• Runs consult tracking reports to follow-up on appointment scheduling and completion of consults;
• Conducts training on all aspects of care in the community programs.

Work Schedule: Full-time, Monday through Friday, 800 am - 4:30 pm
Recruitment & Relocation Incentives: Not authorized
Financial Disclosure Report: Not Required

Travel Required

• Not Required

Relocation Authorized

• No

Job Requirements

Key Requirements

• Must be a U.S. citizen
• Subject to a background/security investigation
• Designated and/or random drug testing may be required
• Selective Service Registration is required for males born after 12/31/1959
• May be required to serve a probationary period.

Qualifications

English Language Proficiency: In accordance with 38 U.S.C. 7402(d), No person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. You must be proficient in basic written and spoken English in order to meet the requirements of this position. The English Language proficiency statement appears as a Selective Placement Factor on the Assessment Questionnaire.
PLUS
EXPERIENCE: You must have at least one (1) full year of specialized experience related to the work of this position that has given you the particular knowledge, skills, and abilities required to successfully perform the duties of a Claims Assistant. Specialized experience may have been gained in a medical office or hospital setting processing medical claims screening new consults for community care for eligibility, specialty service requests, duplication and appropriateness of sending patient to community provider; verifying eligibility for each of the community care programs to include outpatient, inpatient and emergency care; reviewing insurance, patient status and conditions before administrative eligibility is verified; providing community care technical assistance to patients, their beneficiaries and/or personal representatives regarding entitlement and guidelines for the authorization of treatment at facilities expense; running consult tracking reports to follow-up on appointment scheduling and completion of consults; conducting training on all aspects of care in a community programs.
-OR-
EDUCATION: You must have successfully completed four (4) years of education above the high school level in any field which high school graduation or the equivalent is the normal prerequisite. Four years of progressive study or 120 semester hours meets the degree requirements (the course work must have been equivalent to at least the junior-and senior-year levels of a baccalaureate program). This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. NOTE: You must submit a copy of your transcript with your application. -OR-
COMBINATION: You must have equivalent combinations of successfully completed post-high school education (beyond the second year) and experience that meets the total experience requirements. NOTE: You must submit a copy of your transcript with your application.

You will be rated on the following Competencies as part of the assessment questionnaire for this position:

INSURANCE

CREATIVE THINKING

TECHNOLOGY APPLICATION
For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://ift.tt/1dO9mm4.

IMPORTANT: 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://ift.tt/1bgzbPg. 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://ift.tt/1fo0xnu.
PHYSICAL REQUIREMENTS: The work is primarily sedentary but also demands some standing, walking, bending, lifting, and carrying of documents and forms. May lift and carry documents to and from copier/scanner/fax. The work will involve typing on a keyboard greater than 50% of the work day. Concentration and sustained performance under prolonged stress is required because of the time factors involved in completing work within deadlines and processing time limits. May spend high percentage of duty day on the telephone. Will be looking at dual computer screens more than 50% of you day to assist in completion of consult.

Security Clearance

Other

Apply

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