Contact Representative

Summary

Serves as a Contact Representative in the Dayton VA Medical Center's Enrollment and Eligibility Unit. Determines Veterans' eligibility and enrollment for VA health care, conducts financial assessments, processes hardship cases, validates military, income, insurance, and demographic information, and supports Emergency Department registration. Uses VES and related systems, explains benefits, prepares correspondence, protects PII/PHI, and coordinates with Veterans and partner agencies.

Duties

Major Duties and Responsibilities Determine and adjudicate Veterans' eligibility and enrollment for VA health care benefits. Apply Title 38 regulations, VHA policies, federal laws, and agency guidance to eligibility determinations. Process enrollment applications and requests received in person, by telephone, fax, mail, online, or referral. Update Veteran demographic, military service, insurance, income, and eligibility information in VES and related systems. Conduct financial assessments, means tests, pharmacy copay exemption reviews, and hardship determinations. Explain eligibility decisions, enrollment requirements, copayments, benefits, and available services to Veterans and representatives. Research and resolve complex eligibility issues involving character of discharge, income verification, military service, and special programs. Process and track Other Than Honorable discharge adjudications and submit applicable referrals and forms to the VA Regional Office. Assist with eligibility determinations for mental health, humanitarian care, presumptive eligibility, MST-related services, and other special programs. Apply eligibility provisions related to OEF/OIF/OND, Caregiver, Camp Lejeune, Agent Orange, PACT Act, COMPACT Act, Burn Pit Registry, Project SHAD, and other emphasis programs. Research Veteran records using VES, VIS, VBMS, DPRIS, ILER, MPI, SHARE, EHRM, and other VA systems. Validate data, execute transmissions, monitor workloads, and correct discrepancies affecting billing, workload credit, and patient care. Identify, verify, and enter health insurance information; scan insurance cards and research missing payer information. Review and update insurance and income information as required for accurate billing and continued eligibility. Generate patient data cards and assist with Veterans Health Identification Card processes. Provide administrative support to the Emergency Department, including patient registration and verification of entitlement to care. Update insurance information using applicable systems and print and verify patient armbands and labels. Monitor the Emergency Department tracking board, direct patients, route inquiries, and coordinate with clinical and administrative staff. Respond to inquiries from Veterans, family members, VA employees, other agencies, and community partners. Coordinate patient-related information and administrative needs with physicians, nurses, social workers, service officers, and other staff. Prepare, review, and issue written correspondence concerning complex eligibility, enrollment, and benefits inquiries. Conduct benefits and enrollment presentations for Veterans, representatives, service organizations, and community groups. Serve as a liaison with the VHA Privacy Officer and process official name and gender-assignment changes in accordance with applicable requirements. Gather and route legal documentation and signed requests for privacy, identity, and demographic updates. Protect personally identifiable information and protected health information in all transactions and communications. Maintain effective working relationships with individuals from diverse socioeconomic, cultural, and educational backgrounds. Prioritize and complete work accurately in a fast-paced environment while exercising sound judgment, initiative, tact, and discretion. Work Schedule: Monday-Friday, 8:00 a.m.- 4:30 p.m. Virtual: This is not a virtual position. Position Description/PD#: Contact Representative/PD92716A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/23/2026. 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-07 position you must have served 52 weeks at the GS-06. 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. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-06 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Specialized experience includes providing administrative support in a healthcare benefits, eligibility, enrollment, insurance, or related customer-service program; applying laws, regulations, and policies to assess and adjudicate eligibility and enrollment; processing applications, financial assessments, hardship requests, and updates involving military service, demographic, income, insurance, and personal information; researching records and resolving complex eligibility issues; using automated systems and databases to enter, retrieve, validate, and transmit data; reviewing reports and correcting discrepancies; supporting emergency department registration and patient flow; preparing correspondence and reports; explaining benefits and requirements to Veterans, families, representatives, and staff; protecting PII and PHI; coordinating with VA services, federal agencies, and community partners; and exercising sound judgment, accuracy, tact, and discretion while managing competing priorities. You will be rated on the following Competencies for this position: Customer Service Health Information Exchange Organization Awareness 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 is mainly sedentary, but may require periods of walking, standing, bending, driving an automobile, etc. Employees frequently carry case files and other similar materials. The work does not require any special physical effort or ability. For more information on these qualification standards, please visit the United States Office of Personnel Manageme