Medical Support Assistant - Health Benefits Advisor
Location: Reno, Nevada
Description: Department Of Veterans Affairs is presently looking of Medical Support Assistant - Health Benefits Advisor right now, this career will be placed in Nevada. More details about this career opportunity kindly see the descriptions. Vacancy Identification Number (VIN): 972699
VA Sierra Nevada Health Care System
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?
As a VA professional, your opportunities are endless. With many openings in the multiple functions of VA, you will have a wide range of opportunities at your fingertips. Not only is it the largest, most technologically advanced integrated health care system in the nation, but we also provide many other services to Veterans through the Benefits Administration and National Cemeteries.
VA encourages persons with disabilities to apply
These vacancies are advertised at the single grade at which this position will be filled above the full performance level.
NOTE: The Professional
Standards Board (a peer-review group) will review the selected candidateÂ's education and experience and recomm! end the step at which the candidate will be placed in that spe! cific grade. The salary is based on the grade and step approved for the selected candidate.
Appointment Information: An applicant selected for this position may be placed into a temporary appointment, not to exceed one year and one day, pending completion of the boarding process.
The purpose of the position is to serve as a Medical Support Assistant (MSA), also known as Health Benefits Advisor, to the Patient Benefits Section which is comprised of Eligibility and Enrollment, Decedent Affairs, Emergency Department check-in and Beneficiary Travel.
The incumbent serves as a Medical Support Assistant in Patient Benefits at the VA Sierra Nevada Health Care System, Reno, Nevada. The incumbent supervises duties related to the receipt, intake, and indexing of health and administrative information. The incumbent will interface with personal computer (PC) applications as well as numerous Vista applications.
The incumbent is responsible for a! wide range of assignments and provides administrative support to the Section, and the clinical staff recovery aspects of this position have a direct impact on the reimbursement of the facility.
As a Medical Support Assistant in the Patient Benefits Section, the incumbent has the primary responsibility for interviewing patients applying for medical benefits. Incumbent explains the benefits each applicant is qualified for in a concise and caring manner. Applications may be received in person, by telephone, by mail, on-line or referral from another VA. Incumbent is responsible for entering demographic, insurance, and income information into the VistA system. This information serves as a base for determining entitlement to medical care as well as bill preparation and collections on all billable episodes of inpatient and outpatient care. Accurate and complete data collection is essential to proper processing of third party collection requirements as mandated by law.
The Health Benefits Advisor MSA functions as the single administ! rative contact for a client during any visit to the VA Sierra Nevada Health Care System. Incumbent is the initial contact point for veteran/sharing agreement/CHAMPUS clients accessing the VA system for the first time, or re-accessing the system after an absence from VA care. When necessary, the incumbent will make telephone contacts with the client to follow-up and complete details from a previous visit.
The work involves the execution of specific rules, regulations, or procedures and typically comprises a complete segment of an assignment or project of broader scope. The purpose of the work is to coordinate the administrative needs of clients with the healthcare team including eligibility, medical record establishment, record documentation and workload to ensure applicants for care receive efficient, cost effective care. The work performed by the incumbent affects various programs within and outside the facility as well as the satisfaction of our health care syste! m clients. The success and future of our customer goals and patient satisfaction will be directly affected by the manner in which the duties of this position are accomplished.
Incumbent has numerous contacts with the veterans, their representatives and family members, staff, outside physicians, attorneys and employees of other agencies in the community and must have a good rapport with other members of the his/her profession. Contacts influence the public image of the facility and the agency. KEY REQUIREMENTS
U.S. Citizenship
Must pass pre-employment examination
English language proficiency required
Background and/or security investigation required
ALL REQUIRED DOCUMENTS - Incomplete packages will be rated INELIGIBLE DUTIES:
Verifies eligibility/entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, computer hospital inquiry (HINQ), Veterans Information Solution ! (VIS), Enrollment System Redesign
(ESR) and other means, such as co! mmunications with VA Regional Office or VA Records Processing Centers. The process of verifying eligibility is complicated and criteria differ for each type of benefit applied for. The incumbent advises the veterans of their entitlement to various medical benefits and discusses co-payment requirements of veterans in discretionary categories. Extreme tact, diplomacy and privacy are required to explain complicated laws in this area.
For new patients, the incumbent must determine eligibility based on the correct application of current laws and regulations governing entitlement to medical benefits. Obtains information on changes in laws, regulations, and/or other pertinent directives that may change basic medical benefit entitlements. Responds to questions involving/requiring a range of eligibility and benefits issues. Incumbent gathers accurate and current demographic, financial and insurance information on each applicant for care and verifies this information on pati! ents already in our system.
Log-In Desk Unit -
works on a rotational basis at the Log-in Desk logging in patients for primary
care appointments and correctly directing patients to their clinic location.
Reviews ICB daily work list and captures insurance updates for all patients
presenting who are listed on the daily work list.
Advises clients on special programs, e.g., Agent Orange, Persian Gulf, Ionizing Radiation, WomenÂ's Health, Combat Veterans etc., and coordinates referrals in a manner that avoids unnecessary referrals to other administrative program managers.
When eligibility is denied, the incumbent notifies the patient in writing with adequate detail and appeal rights and suggests alternative sources for obtaining medical care or refers the patient to another system.
Explains the VAÂ's mandate to collect insurance information to veterans, their families, and other eligible patients. He/she identifies, collects, sc! ans/copies insurance company enrollment identification cards and update! s health insurance information from
all applicants for entry to the VistA serving a major role in the revenue process. The incumbent contributes to the revenue collection process by identifying patients with third party insurance benefits and enters accurate information into the VistA system
Extensive knowledge of the Medical Center and policies is required to respond to inquiries from veterans, Medical Center staff and other agencies regarding applying for care, eligibility, etc.
Accurately generates patient data cards for veterans applying for care using the Veterans Identification Card (VIC) system and proofing two (2) forms of identification from the veteran. Reviews reports and corrects registration errors until cards transmit properly. Incumbent monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption! programs as mandated by law. Failure to perform these audits and to timely update the information may result in inaccurate billing of a patient and result in missed crediting of workload visits for the facility. Impact to the Clinic and patients are costly and time consuming to correct. Counsels patients regarding their financial responsibilities relative to care they will receive. Ensures all pertinent documentation is collected and filed for each visit.
Incumbent identifies and collates health insurance information from all applicants for entry to the VistA, copies or scans insurance company enrollment identification cards, researches employers as needed to obtain complete data when applicants
do not have complete information.
Makes correction to VistA database based on information obtained from clients. This information is of critical importance in order to ensure patients are contacted timely about appointments, are able to be contacted by provide! rs when unusual or abnormal circumstances arise during treatment, and t! o ensure patients show up for appointments thereby fully utilizing expensive clinical resources. When proper documentation is not available, initiates a search for the needed verification and advise the patients of the situation. Determines the medical care benefits to which the patient has entitlement. Answer routine inquiries.
Supports patient safety standards using the correct Veterans Affairs identification of all patients through the use of two forms of identification, name and full Social Security Number. The patient may also present the Veterans Identification Card (VIC) for identification. He/she must use each interaction with the patient to validate and update patient demographic information, either in person during check-in or over the phone, to decrease the incidence of returned mail due to incorrect addresses and inability to contact patient by phone due to incorrect number.
Incumbent must screen/receive phone calls in a courteous and timely ma! nner, determine the nature of requests to respond to inquiries from veterans, Medical Center staff and other agencies regarding applying for care, eligibility, and provide the
information desired using privacy rules and established clinic processes.
Advises veterans on non-medical benefits of a routine nature and refers veterans to VBA benefit counselors for information on benefits of a complex nature.
Decedent Affairs Unit: Handles Details of Patient Death Cases
Incumbent will also perform duties in the Decedent Affairs unit of the section. Handles all administrative details of patientsÂ' death cases including determining eligibility and counseling families on death benefits, preparation of all necessary paperwork, and release of monies, valuables, and personal effects.
Establishes liaison between the medical facility and the burial and other benefits. Researches all sources to determine legal next of kin. Assists the funeral ! home in obtaining payment for services rendered. Provides next of kin w! ith all information and assistance in order to assure funeral burial arrangements conform to the desires of the next of kin.
Prepares forms/correspondence to finalize patient business such as death certificates, forms needed to transfer personal possessions and monies of deceased patients to their beneficiaries, forms for donation of body parts for research or transplant, etc.
Obtains family consent for medical procedures including autopsies, surgical procedures, etc. Makes funeral and burial arrangements for all deaths occurring at the medical facility or if there is no next of kin.
Emergency Department Unit
Oversee all clerical functions related to ED. MSA is responsible for all patient appointments for the ED. Receives all incoming communication for the department; face to face, written and telephone. Obtains medical records when necessary for patients being seen in ED either hard chart or Vista Web for visitors.
MSA coordinat! es with travel, volunteer service and agent cashier to meet patient transportation and deposit needs. Utilizes consult tracking in CPRS in order to stay compliant with appointment requests. Handles all release of information requests and medical record transfers for ED patients. MSA is responsible for ambulance report and tracking. prepares all necessary patient records, MSA is responsible to order necessary office supplies and obtain them from the warehouse (or request delivery when unable to leave dept). MSA processes all IRM & electronic work order requests for ED staff and maintains records of
requests and completed items. MSA is responsible for entering new patient information into the load edit program when a visiting patient presents for emergency treatment. MSA also coordinates with EEC to facilitate the enrollment process for new patients. MSA is responsible for updating policy binders.
Incumbent must be able to interpret and communicate requirements o! f VHA Scheduling Directives and complete accurate scheduling responsibi! lities and assist in training other MSA levels as follows:
Assisting nursing staff with patient transfers. MSA performs main operator duties when no call center operator is present.
Beneficiary Travel Unit
Incumbent will also perform duties in the Beneficiary Travel Program for the facility. The Beneficiary Travel program provides transportation at Government expense to beneficiaries and their attendants traveling to and from VA facilities and other places for the purpose of examination, treatment or care. This will include correctly determining eligibility for the program, and processing requests. It will also include correctly determining which of several fund control points to utilize, obligating funds, maintaining manual and electronic accounting records, performing regular reconciliations and adjusting account balances. Contacts approving official to authorize obligations and requests for additions, deductions, and/or movement of funds. Makes! necessary changes to fund control points.
Arranges all modes of transportation via air ambulance, commercial air, taxi, ambulance, bus and/or independent transports. May correspond with physician, traveler, social worker or CBOC representative and vendor to determine the most dependable and economical mode of transportation. Prepares appropriate documentation and/or scheduling for traveler according to government rates or substantial rates.
In the performance of official duties, the employee has regular access to printed and electronic files containing sensitive data which must be protected under the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA procedures. The employee is responsible for (1) protecting those data from unauthorized release of form loss, alteration, or unauthorized deletion, and (2) following applicable regulations and instructions regarding access to computerized file! s and user ADP security as set out in the computer access agreement whi! ch the employee signs.
The employee will have regular and recurring contact with personnel external to the agency for the obtainment of services, sharing of information and authorization, clarification or denial of payments.
Assures that all appropriate VA forms are used correctly and regulations followed.
Additional duties can include section timekeeping and supply requisition.
Relocation/Recruitment incentive has not been approved for this position
Work Schedule: Full-Time, 40 hours per week
This position is covered by the bargaining unit QUALIFICATIONS REQUIRED:
BASIC REQUIREMENTS:
Citizenship: Citizen of the United States (Non-citizens may be appointed when it is not
possible to recruit qualified candidates in accordance with chapter 3, section A, paragraph 3g, this part.)
Physical Requirements: Applicants must meet physical standards for the position. A physical ! examination prior to placement is required. The work is sedentary. However, there may be some walking, standing, bending, carrying of light items such as papers, books, small parts. No special physical demands are required to perform the work. Hearing aids permitted. See VA Directive and Handbook 5019
English Language Proficiency: Individuals appointed to direct patient care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d) and 7407(d)
Specialized Experience: Experience that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for the occupation in the organization. Applicants who have the 1 year of appropriate sp! ecialized experience, as indicated in the table, are not required by th! is standard to have general experience, education above the high school level, or any additional specialized experience to meet the minimum qualification requirements. Examples of specialized experience include technical or administrative supervision.
GRADE DETERMINATIONS:
GS-06: Federal applicants must have served a minimum of 52 weeks at or above the GS-05 level in Federal Service to meet the time-in-grade requirements for GS-06
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.
References: VA Handbook 5005 http://www.va.gov/ohrm/joblistings/VAQualStds.doc
APPLICANTS PLEASE NOTE: Education is generally not substituted for Specialized Experience at this grade level.
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order
for it to be credited towards qualifications (part! icularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html
All education claimed by applicants will be verified by the appointing agency accordingly. 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.
Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference on their application or résumé. Applicants claiming preference based on service-connected disability, or based on being the spouse or mother of a disabled or deceased Veteran, must complete an SF 15, Application for 10-Point Veteran Preference. Vet! erans who are still in the service may be granted tentative preference ! on the basis of information contained in their applications, but they must produce a DD Form 214 or other proof prior to appointment to document entitlement to preference. For more information on Veterans' Preference, please visit http://www.fedshirevets.gov/job/veterans.aspx HOW YOU WILL BE EVALUATED:
Your application, résumé and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment. You may also be evaluated based upon the question responses you provide during a structured interview. In responding to structured interview questions you should be sure to cite specific examples of experience, explain exactly what you did, and the outcome. BENEFITS:
Working for the Department of Veterans Affairs offers a comprehensive benefits package that includes, in part, paid vacation, sick leave, holidays, life insurance, health benefits, thrift savings plan, and participatio! n in the Federal Employees Retirement System. In addition to traditional "dollars and cents" benefits, we offer a range of benefits to help balance work and life. For more information please visit us at http://www.va.gov/JOBS/Job_Benefits/benefits.asp OTHER INFORMATION:
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
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If you were eligible to this career, please send us your resume, with salary requirements and a resume to Department Of Veterans Affairs.
Interested on this career, just click on the Apply button, you will be redirected to the official website
This career starts available on: Fri, 04 Oct 2013 19:33:20 GMT
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