Advanced Medical Support Assistant (Enrollment & Eligibility Office)

Summary

This position serves as an Advanced Medical Support Assistant (AMSA) in the Health Benefits/ Eligibility and Enrollment Office at the Charlotte HCC and is primarily responsible for determining eligibility and entitlement to VA healthcare benefits to include interviewing patients applying for medical benefits. Patient applications may be received in person, by telephone, mail or online. Incumbent is responsible for entering demographic data, insurance, and income information.

Duties

The incumbent is responsible for a wide range of assignments and provides administrative support to the Enrollment Office. This is an advanced level AMSA position. The incumbent serves as an Advanced Medical Support Assistant (AMSA) for Health Benefits and the Enrollment Office. Extensive knowledge of the medical center policies and directives is required to respond to inquiries from Veterans, staff, and other agencies regarding applying for health care, eligibility, etc. The incumbent will be the first point of contact for complex calls. The incumbent will receive incoming calls from patients, family members, and outside agencies. They will independently use and navigate through Veterans Health Information Systems, technology architecture (VISTA) and the electronic health record (CPRS) obtaining and identifying information while determining the nature of the call. The full performance level AMSA will know how to properly document notes in the patient's electronic health record and relay messages and direct calls appropriately. The incumbent verifies eligibility and entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, Veterans Information Solution (VIS), Veterans Enrollment System (VES), Common Security Employee Manager (CSEM), Veterans Benefits Management System (VBMS), and other means and communication avenues to VA and external entities. The incumbent manages catastrophic disability and hardship requests. The process of verifying eligibility is complex and criteria differ for each type of benefit applied for. The incumbent advises Veterans of their entitlement for multiple medical benefits and discusses co-payment requirements of Veterans discretionary categories. Tact, diplomacy, and privacy are required to explain complicated laws in this area. The incumbent accurately generates patient data card requests for Veterans applying for care using the Veterans Identification Card (VIC) system, Veteran Health Identification Card (VHIC) system, and other systems as necessary. The incumbent reviews enrolled patient information to perform updates to health insurance data, income assessments, pharmacy co-pay exemptions as mandated by law. Incumbent completes all assigned applications to ensure that Veterans are enrolled timely. The incumbent is responsible for monitoring the NEAR list and scheduling new patient appointments in accordance with VHA directives, established guidelines, and local policies. Other duties as assigned. VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo Work Schedule: Monday-Friday 8:00am-4:30pm Telework: Not Available Virtual: This is not a virtual position.

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: (A) Citizenship. Citizen of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.g.). (B). Experience: None (C). Education. High school diploma, General Education Development equivalency certificate, or proficiency certificate from a State or territorial-level Board or Department of Education. (D).Licensure/Certification/Registration. None. (E). Grandfathering Provision. Employees in VHA in this occupation, under a permanent, appropriate, and legal placement on the effective date of the qualification standard, are considered to have met all qualification requirements for the grade and/or assignment held, including positive education and registration/certification where applicable. For employees who do not meet all the basic or assignment-specific requirements in this standard but met the qualifications applicable to the position at the time they were appointed, the following provisions apply: (1) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed on a temporary or permanent basis until they fully meet the basic requirements of the standard. (2) Employees retained in this occupation under this provision who subsequently leave the occupation lose protected status and must meet the full VA qualification standard requirements in effect at the time of re-entry to the occupation. Grade Determinations: Medical Support Assistant (Advanced), GS-6 Experience. One year of experience equivalent to the [GS-5] grade level Demonstrated Knowledge, Skills, and Abilities. Candidates must demonstrate [all of] the KSAs below: (a) Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. (b) Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. (c) Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. (d) Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g., medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. (e) Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. (f) Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. Assignment. For all assignments above the FPL, the higher-level duties must be of significant scope, administrative independence, complexity, and range of variety as described in this standard at the specified grade level and be performed by the incumbent at least 25% of the time. At the advanced level, the Medical Support Assistant (Advanced) (AMSA) performs difficult and responsible specialized and expert administrative patient support while working collaboratively in an interdisciplinary coordinated care delivery model. Work involves specialized administrative judgment and the flexible use of a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or care in the community resources. Recommend changes to existing clinic procedures based on current administrative guidelines. Expertise in utilizing numerous advanced patient systems in support of multiple clinics involved in an interdisciplinary coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability (utilization) to ensure that clinic schedules are closely monitored to effectively support the needs of the clinics, and makes adjustments as necessary. MSAs at this leve