Contact Representative

The purpose of the position is to serve as a Health Benefits Unit Contact Representative to the Health Administration Service (HAS), under the direct supervision of the Supervisory Medical Administrative Specialist. The incumbent is responsible for a wide range of assignments and provides administrative support to the Section; the cost recovery aspects of this position have a direct impact on the reimbursement of the facility.

Health Benefits Contact Representative Serves as the subject-matter expert and is responsible for applying an extensive body of rules and regulations relative to Veterans Eligibility for VA healthcare benefits, interpretation of relevant laws, VHA guidelines and regulations, and other federal agency policies is required to ensure that timely and appropriate measures are taken throughout data collection and data entry processes. Processing requests to update veterans personal, eligibility and enrollment information, entering demographic, insurance, and income information. Serves as a base for determining entitlement to medical care as well as bill preparation and collection on all billable episodes of inpatient and outpatient care. Accurate and complete data collection is essential to proper processing of third-party collection requirements as mandated by law. Serve as expert benefit representative to HAS Leadership and support the management information components of all health eligibility related programs. Provides administrative support and collaborates with inpatient staffing personnel such as Physicians, Physician's Assistants, Nurses, Advanced Registered Nurse Practitioners, Dietitians, Social Workers, and other administrative and professional staff throughout AAVAMC area transitioning patients identified as ineligible for VA patient care. Accurately generates patient data cards for veterans through the Identity Management Toolkit for proofing identity and the Veterans Health Identification Card (VHIC) System. Monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs as mandated by law. Correspondence Prepares written correspondence for a broad spectrum of complex inquiries from intel and external customers by independently recognizing issues, topics, or problems. Prepares, composes, and reviews correspondence prepared for the purpose of obtaining or supplying information. Resolves conflicting or inconsistent information by dealing with various VA offices, sorting out errors and researching past transactions, cases or events. Consult Coordination/New Enrollment Appointment Request (NEAR) List Managing the NEAR list and electronic wait list to verify and validate accuracy and resolve issues; providing input during team meetings and to assist in resolving problems having to do with enrollment issues, or panel assignments. Generates and monitors enrolled patient data base information for accurate health insurance data Customer Service Provide exceptional customer service by exceeding the customer's expectations Actively listen to customers with respect and concern; the incumbent will pay attention to the details of the customer's needs and help the customer arrive at a satisfactory solution to the problem Communicates and interacts with patients in a manner which is appropriate to cognitive, emotional, and chronological maturation needs of the adult and/or geriatric patient. Perform all other related duties as assigned. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday-Friday 8:00am to 4:30pm Compressed/Flexible: Not Authorized Virtual: This is not a virtual position. Position Description/PD#: Contact Representative/PD92690A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

There is no educational substitution at this grade level.