Program Support Clerk
Major Duties Include but are not limited to:
Manages clinical, administrative, and financial information in multiple information systems; Reviews claims in a Fee Basis Claims System Distribution module and links the claims to the appropriate patient; Provides proficient customer service thru a call center network; Receives telephone calls regarding patients eligibility and/or entitlement to benefits; Provides information regarding eligibility requirements for programs or specific claims with vendors, patients, or service officers; Routes claims and eligibility issues to the appropriate internal department contacts; Reviews and processes medical claims information such as Non-VA care and Medicare; Determines if services were pre-authorized or unauthorized by reviewing data fields on the claims; and Interacts with patients and/or care givers to assist in filing claims and explains what action is needed by the patient to support their claim(s). Promotion Potential:
This position is announced at the full performance level of GS-5. Work Schedule:
Monday-Friday, 8:
00AM-4:
30PM Telework:
Not Available Virtual:
This is not a virtual position. This position is physically located onsite. Position Description/PD#:
Program Support Clerk/PD04089A Relocation/Recruitment Incentives:
Not Authorized Financial Disclosure Report:
Not required To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/12/2020. Time-In-Grade Requirement (GS-5):
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-5 position you must have served 52 weeks at the GS-4. 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 VA employees applying with CTAP eligibility. You may qualify based on your experience and/or education as described below. Specialized Experience (GS-5):
You must have one year of specialized experience equivalent to at least the next lower grade (GS-4) in the normal line of progression for the occupation in the organization. Examples of Specialized Experience includes (but are not limited to):
1) Receives and processes all mail to include date stamping (if appropriate), sorting, and scanning 2) Reviews incoming correspondence to determine the nature of questions and/or issues, and directs inquiry to the proper area for resolution 3) Maintains the daily management of mail distribution such as medical claims verification, authorization data entry, and record filings 4) Prepares outgoing correspondence to include sorting mail, using paper folding machines, and verifying addresses 5) Views and indexes veterans and/or patients documentation in computerized records systems 6) Notifies voucher examiners that medical documentation has been received to initiate further action on rejected and/or suspended claims 7) Assists vendors with requests regarding payment issues, correct addresses, and agency correspondence OR, Education:
Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Bachelors Degree. 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 an Associates Degree. You will be rated on the following Competencies for this position:
CommunicationsComputer SkillsCustomer ServiceInsurance 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:
Work is generally sedentary in nature that sometimes may require light lifting and transportation of records. Work is performed in a variety of office settings exposing the incumbent to the normal office hazards. 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/.
Estimated Salary: $20 to $28 per hour based on qualifications.
Manages clinical, administrative, and financial information in multiple information systems; Reviews claims in a Fee Basis Claims System Distribution module and links the claims to the appropriate patient; Provides proficient customer service thru a call center network; Receives telephone calls regarding patients eligibility and/or entitlement to benefits; Provides information regarding eligibility requirements for programs or specific claims with vendors, patients, or service officers; Routes claims and eligibility issues to the appropriate internal department contacts; Reviews and processes medical claims information such as Non-VA care and Medicare; Determines if services were pre-authorized or unauthorized by reviewing data fields on the claims; and Interacts with patients and/or care givers to assist in filing claims and explains what action is needed by the patient to support their claim(s). Promotion Potential:
This position is announced at the full performance level of GS-5. Work Schedule:
Monday-Friday, 8:
00AM-4:
30PM Telework:
Not Available Virtual:
This is not a virtual position. This position is physically located onsite. Position Description/PD#:
Program Support Clerk/PD04089A Relocation/Recruitment Incentives:
Not Authorized Financial Disclosure Report:
Not required To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/12/2020. Time-In-Grade Requirement (GS-5):
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-5 position you must have served 52 weeks at the GS-4. 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 VA employees applying with CTAP eligibility. You may qualify based on your experience and/or education as described below. Specialized Experience (GS-5):
You must have one year of specialized experience equivalent to at least the next lower grade (GS-4) in the normal line of progression for the occupation in the organization. Examples of Specialized Experience includes (but are not limited to):
1) Receives and processes all mail to include date stamping (if appropriate), sorting, and scanning 2) Reviews incoming correspondence to determine the nature of questions and/or issues, and directs inquiry to the proper area for resolution 3) Maintains the daily management of mail distribution such as medical claims verification, authorization data entry, and record filings 4) Prepares outgoing correspondence to include sorting mail, using paper folding machines, and verifying addresses 5) Views and indexes veterans and/or patients documentation in computerized records systems 6) Notifies voucher examiners that medical documentation has been received to initiate further action on rejected and/or suspended claims 7) Assists vendors with requests regarding payment issues, correct addresses, and agency correspondence OR, Education:
Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Bachelors Degree. 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 an Associates Degree. You will be rated on the following Competencies for this position:
CommunicationsComputer SkillsCustomer ServiceInsurance 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:
Work is generally sedentary in nature that sometimes may require light lifting and transportation of records. Work is performed in a variety of office settings exposing the incumbent to the normal office hazards. 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/.
- Department:
0303 Miscellaneous Clerk And Assistant - Salary Range:
$34,916 to $45,393 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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