Medical Support Assistant (Advanced)

Summary

The incumbent serves as Advanced Medical Support Assistant, advising on health benefits, in the Eligibility and Enrollment Section at CTVHCS. The incumbent is primarily responsible for the intake and administrative processes for Veterans and beneficiaries applying for medical services at our Health Care System or to any of its Community Based Outpatient Clinics (CBOCs) and satellite clinics. Attention to detail is mandatory for the duties involved in this position.

Duties

Major duties include, but are not limited to: Incumbent interviews and registers applicants to determine eligibility and legal entitlement of applicants for health care, including assignment into the appropriate enrollment priority group. Applications may be received in person, by mail, by internet, by fax, or by referral from another VA facility. Verifies eligibility using various methods, including income assessments, military discharge documents, hospital inquiry (HINQ), benefits delivery network (BON), Veteran information solutions (VIS), and other means such as communications with a VA Regional Office. Administers income assessments (means test). Advises and counsels Veterans and their beneficiaries or representatives of financial obligations, co-pay requirements, and their rights to appeal. Deals with and resolves complex eligibility, co-pay, and insurance questions that arise. Displays adaptability in dealing with a wide range of individuals as necessary. Explains to each individual the specific conditions or actions that could affect their co-pay status or eligibility for benefits. Informs Veterans of their responsibility to report changes. Incumbent is responsible for gathering, entering, and updating demographic, employment, insurance, and income verification into the Enrollment System (ES), Veteran Integrated Software Technology (VistA), and other related programs. Incumbent captures specific types of eligibility such as OEF/OIF/OND, Combat, Veteran, etc. Information may be gathered by mail, fax, internet, and/or in person. The incumbent schedules all new patient appointments, to include new patient primary care appointments, lab appointments and orders, OEF/OIF/OND social work appointments, new patient orientation/education appointments, and phone or video appointments if required. This also requires answering phones that are on an Automatic Call Distribution (ACD) system. Work Schedule: Monday - Friday; 7:30am - 4:00pm or 8:30am - 4:30pm Recruitment/Relocation Incentives (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Pay: Competitive salary and regular salary increases. When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade). Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience. Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child. Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66. Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 50344 Permanent Change of Station (PCS): Not Authorized

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: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Experience. No experience required. Education. High school diploma, General Education Development equivalency certificate, or proficiency certificate from a State or territorial- level Board or Department of Education. Licensure/Certification/Registration. None Physical Requirements. See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. English Language Proficiency. Candidates must be proficient in spoken and written English in accordance with 38 U.S.C. § 7403(f). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-06 Medical Support Assistant (Advanced) Experience: One year of creditable experience equivalent to the next lower grade (GS-05). Knowledge, Skills, and Abilities (KSAs): In addition to the experience above, the candidate must demonstrate the following KSAs: (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 app