Tulsa, OK, 74152, USA
17 hours ago
Health Benefits Assistant
Summary The position is assigned to the Business Office of the Eastern Oklahoma Health Care System and performs a broad range of administrative duties to support Veteran Benefits and registration and intake activities within the Medical Center. This includes supporting the business unit that administers health and related benefits within an integrated system of VA health care resources and health care access points. Responsibilities Major duties of this position include, but are not limited to: Performs technical activities involved with screening, processing, and assisting Veterans, non-Veterans, and beneficiaries seeking multiple medical treatment benefits. Assists MSA staff with loading VA Registry exam requests and traveling Veterans into database upon check in. Advising applicants of the health benefits to which they are legally entitled, responding to technical questions regarding Veterans' administrative rights and situational eligibility for healthcare; and providing Veterans with administrative advice and guidance. Provides information regarding benefits to Veterans and responds to complex questions involving regulations and/or beneficiary entitlement. Communicate results to patients, families, agency employees, and Veterans organizations. Provides follow up with the PCMM coordinator for assignment to the Primary Care team after the initial appointment is scheduled. Works with Veterans Health Information Systems Technology enrollment software. Monitors enrolled patient database information to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs. Facilitates receipt of all VA & Non-VA medical records to support indexing of records to records system ensures records are available for review upon vesting appointment. Reviews and processes VA healthcare eligibility in conjunction with Department of Defense (DoD) Sharing Agreements (TriCare & CHAMPVA) to determine eligibility for VA health care referencing multiple sources, such as the Health Eligibility Center (HEC), VIS, and or/ military discharge papers to assign a priority group to the Veteran. Reviews and processes new and recurring applications (paper, in-person, and electronic) for medical care (e.g., Dental, Behavioral Health, Geriatrics and Extended Care, Diagnostic and Therapeutic, etc.) through applying the appropriate regulatory authority to each program. Processes re-enrollment into the system and assists Veterans in changing facilities if necessary. Work Schedule: Full Time, Monday through Friday, 8:00 am to 4:30 pm Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Assistant/PD14665A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized 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/trial period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/04/2025. 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-05 position you must have served 52 weeks at the GS-04. 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 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. Examples of specialized experience would typically include, but are not limited to: . Knowledge of pertinent laws, federal regulations, polices guidelines, VHA directives, handbooks, and procedures relating to Veteran's benefits to ensure that all Veterans, patients, potential beneficiaries, staff, and other stakeholders are accurately informed and efficiently enrolled. Comprehensive knowledge of Eastern Oklahoma VA Healthcare System memorandums, administrative procedures and processes, standard operating procedures, internal policies, and other guidance related to such areas as eligibility for VA medical benefits, non-VA care eligibility, outpatient programs, patient scheduling, admissions and discharges, patient transfers, VA healthcare network capabilities for patient referrals and transfers, employee health, beneficiary travel, inpatient and outpatient statistical reporting, and others related Medical Center organization and administration.; Knowledge of the Privacy Act, the Freedom of Information Act, HIPPA guidelines, and other authorities with respect to release of information and established guidelines to preserve the confidentiality of record contents.; Extensive knowledge of the organizational and interdepartmental relationships of an active Medical Center to effectively relay the medical benefits package to all inquiring parties.; Comprehensive knowledge and the ability to use several computer systems, (e.g., VistA; HEC Enrollment System Expansion, CPRS, VIS, VBMS, SHARE, etc.), and the requisite knowledge for using multiple menu options within those systems. Including knowledge of the varied functions of computer spreadsheets, database computer applications, etc. to produce and maintain a wide variety of documents.; Ability to participate in studies which may require, statistical measurement, data analysis, and report preparation using databases and dashboards. Prepares reports as required and makes reasonable recommendations for system or process improvement. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have have four years of education beyond the high school level. 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 the high school level in excess of 60 credits. You will be rated on the following Competencies for this position: Communication Computer Skills Customer Service (Clerical/Technical) Manages and Organizes Information 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 of the Incumbent is primarily sedentary, involving sitting for extended periods while working on a computer or performing administrative tasks. Occasionally, light physical effort may be required, such as walking short distances, climbing stairs, and carrying light office items like files, documents, or office supplies. This position does not typically involve strenuous physical activity. 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 This job opportunity announcement may be used to fill additional vacancies. 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.
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