Program Support Clerk (OA)
Some of the duties may include but are not limited to:
Responds to questions that arise related to third party health insurance. Collects insurance information from individual insurance carriers, patients and/or patients families, employers, attorney, guardian or other responsible parties to obtain all necessary information. Interprets insurance policy language to ensure proper information is obtained. Verifies reimbursable insurance with carriers by obtaining specific benefits of policy (e.g., pre-certification and/or primary contact phone number) Resolves complex insurance questions that arise from patients and staff. Initiates contact with insurance agencies or review organizations to provide precertification, continued stay and discharge information where required in order to avoid monetary penalties Assists the Supervisor in maintaining Standard Operating Procedures and training manuals. Participates in the development of training plans for intake and customer service staff. Participates in collective projects to address issues identified by management in their efforts to maintain accurate insurance file information. Work Schedule:
Monday - Friday; 8:
00 am to 4:
30 pm Telework:
Not available Virtual:
This is not a virtual position. Position Description/PD#:
Program Support Clerk (OA)/PD#11154-A Relocation/Recruitment Incentives:
Not authorized Financial Disclosure Report:
Not required FLSA:
Non-Exempt Bargaining Unit:
Yes To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/16/2020. 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-05 position you must have served 52 weeks at the GS-04. 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. 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 and/or education as described below:
Specialized
Experience:
You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Knowledge of third party insurance coverage and eligibility in order to interpret policy;knowledge of VA regulations, Public Laws, Directives, policy memorandum, regarding enrollment, eligibility, billing, and reimbursement from veterans and third party payers; skill in interviewing individuals with diverse viewpoints and conflicting goals in order to collect a variety of personal information; ability to work independently, demonstrating flexibility and sound judgment in selecting appropriate courses of action OR, Education:
Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 4 years above high school. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. A transcript must be submitted with your application if you are basing all or part of your qualifications on education . OR, Combination:
Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-05. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position. You will be rated on the following Competencies for this position:
CommunicationComputer SkillsInsuranceTechnical Credibility 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 sedentary, but requires some bending, walking, and standing. No unusual physical requirements are present.
Estimated Salary: $20 to $28 per hour based on qualifications.
Responds to questions that arise related to third party health insurance. Collects insurance information from individual insurance carriers, patients and/or patients families, employers, attorney, guardian or other responsible parties to obtain all necessary information. Interprets insurance policy language to ensure proper information is obtained. Verifies reimbursable insurance with carriers by obtaining specific benefits of policy (e.g., pre-certification and/or primary contact phone number) Resolves complex insurance questions that arise from patients and staff. Initiates contact with insurance agencies or review organizations to provide precertification, continued stay and discharge information where required in order to avoid monetary penalties Assists the Supervisor in maintaining Standard Operating Procedures and training manuals. Participates in the development of training plans for intake and customer service staff. Participates in collective projects to address issues identified by management in their efforts to maintain accurate insurance file information. Work Schedule:
Monday - Friday; 8:
00 am to 4:
30 pm Telework:
Not available Virtual:
This is not a virtual position. Position Description/PD#:
Program Support Clerk (OA)/PD#11154-A Relocation/Recruitment Incentives:
Not authorized Financial Disclosure Report:
Not required FLSA:
Non-Exempt Bargaining Unit:
Yes To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/16/2020. 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-05 position you must have served 52 weeks at the GS-04. 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. 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 and/or education as described below:
Specialized
Experience:
You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
Knowledge of third party insurance coverage and eligibility in order to interpret policy;knowledge of VA regulations, Public Laws, Directives, policy memorandum, regarding enrollment, eligibility, billing, and reimbursement from veterans and third party payers; skill in interviewing individuals with diverse viewpoints and conflicting goals in order to collect a variety of personal information; ability to work independently, demonstrating flexibility and sound judgment in selecting appropriate courses of action OR, Education:
Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 4 years above high school. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. A transcript must be submitted with your application if you are basing all or part of your qualifications on education . OR, Combination:
Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-05. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position. You will be rated on the following Competencies for this position:
CommunicationComputer SkillsInsuranceTechnical Credibility 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 sedentary, but requires some bending, walking, and standing. No unusual physical requirements are present.
- Department:
0303 Miscellaneous Clerk And Assistant - Salary Range:
$42,592 to $55,372 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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