Department of Veterans Affairs
(VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service.
If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA.
The VA is committed to hiring Veterans
The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission.
The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define who we are, our culture, and how we care for Veterans, their families and other beneficiaries. The Values are
America's Veterans need you!
To find out more, go to
You must be a U.S. citizen to apply for this job.
You will be subject to a background/suitability investigation.
The Claims Assistant (Office Automation) position is located in the Fee Basis section of the Patient Administrative Service at the Oscar G. Johnson VA Medical Center in Iron Mountain, Michigan. The work entails processing a wide variety of transactions for all areas of purchased care. Major duties and responsibilities include but are not limited to:
Establish administrative entitlement to outpatient purchased care benefits including purchased care outpatient medical, homemaker home health, skilled nursing, drugs and medicine, state home, community nursing home, dental, inpatient authorized, unauthorized and mill bill;
Receive, scan, process and manage claims in the Fee Basis Claims System (FBCS);
Manage fund control points to ensure accurate data to enable forecasting for future budgets, needs and fiscal year requirements;
Enter authorizations, identify fund control point/obligation and maintain fund spreadsheets;
Scan medical records;
Provide letters to veterans regarding authorized services;
Process appeals of all decisions on denial of benefits administered through Fee Service;
Maintain statistical data to be compiled in monthly expenditure reports; and
Perform all other duties as assigned.
Work Schedule: On the Assessment Questionnaire, you may choose one (1) or more appointment types to apply for the Claims Asst (OA):
Two (2) Full-Time PERMANENT; Monday through Friday 8am until 4:30pm
One (1) Full-Time TEMPORARY not to exceed 1 year and 1 day position; Monday through Friday 8am until 4:30pm;
: This is a full-time,
(not-to-exceed 1 year) position. This appointment may be renewed for additional service in accordance with Agency needs. Temporary positions do not offer health or life insurance benefits and may be terminated at any time before the expiration date. The appointment to a temporary position does not confer eligibility for promotion or reassignment to other positions or the ability to be non-competitively converted to permanent employment.
***RELOCATION EXPENSES AND/OR INCENTIVES ARE NOT AUTHORIZED***
This position requires the skills of a qualified typist. In addition to meeting the experience and/or education requirements, you must be able to type at least 40 words per minute.
To qualify for this position at the GS-5 level you must meet one of the following minimum qualification requirements:
One (1) year of specialized experience working in a medical office or similar setting performing clerical work that involved processing payments; processing, researching and auditing medical claims; interpreting legal requirements and policies; verifying insurance eligibility for treatment or care; preparing correspondence and reports using software such as Microsoft Office; and responding to questions regarding bills, claims and insurance benefits. This experience must be equivalent to the next lower grade level (GS-4) in Federal service. NOTE: Experience must be fully documented on your resume and must include job title, duties, month & year start/end dates AND hours worked per week.
Successful completion of four (4) years above high school in any field which high school graduation or the equivalent is the normal prerequisite. You must submit transcripts with your application.
Education cannot be credited without the proper documentation.
A combination of successfully completed post-high school education (beyond the second year) and specialized experience, as described above, to meet the full requirement. You must submit transcripts with your application.
Education cannot be credited without the proper documentation.
You will be rated on the following Knowledge, Skills, Abilities and Other characteristics (KSAOs) as part of the assessment questionnaire for this position:
KNOWLEDGE OF REGULATIONS, POLICY AND PROCEDURES
SKILL AND ABILITY TO PROCESS FEE BASIS PROGRAM INVOICES
ABILITY TO PERFORM GENERAL OFFICE SUPPORT WORK RELATED TO CLAIMS ACTIVITIES
INTERPERSONAL AND COMMUNICATION SKILLS
ABILITY TO ANSWER CORRESPONDENCE RELATED TO CLAIMS
SKILL IN THE USE OF OFFICE AUTOMATION SYSTEMS AND SOFTWARE APPLICATIONS
The work is primarily performed in an adequately lighted climate controlled office setting. The Claims Assistant may work in close proximity to patients and may be exposed to communicable diseases and patients with a history of psychiatric problems. The work involves a moderate amount of walking, the occasional pushing or pulling of a cart, or bending/reaching to obtain objects off shelves.
For more information on these qualification standards, please visit the United States Office of Personnel Management's website at
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. If your resume does not support your questionnaire answers, we will not allow credit for your response(s).
APPLICANTS PLEASE NOTE:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Please refer to this
to ensure proper accreditation and for foreign education requirements.
When applying for Federal jobs, eligible veterans should claim preference on the Occupational Questionnaire in the section provided and provide a legible copy of DD-214(s) showing all dates of service as well as character of service (honorable, general, etc.). Additionally, veterans with service-connected disability of 10% or more must also submit a copy of their official statement from the Department of Veterans Affairs, or from a branch of the Armed Forces, certifying their service-connected disability and/or their receipt of compensation for service-connected disability. If the military member is within 120 days of separation and does not yet have a DD214, the member may instead submit any written document from the armed forces that certifies the service member is expected to be discharged or released from active duty service in the armed forces under honorable conditions not later than 120 days after the date the certification is signed.
Veterans with service-connected disability of less than 10%, non service-connected disability, and Purple Heart recipients, as-well-as those claiming derived preference for a spouse, widow or widower, or natural mother, should refer to and submit a completed "
SF15, "Application for 10-Point Veteran Preference
," (go to
) and required documentation with your application materials. For more information on Veterans' Preference, please visit
HOW YOU WILL BE EVALUATED:
Applicants will be ranked based on four quality groups, as follows:
Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position;
Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job;
Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.
After the vacancy announcement closes, reviewed applications are evaluated against the questionnaire responses and placed in the appropriate quality group. Qualified veterans will be afforded preference by being placed at the top of the appropriate quality group. Qualifying veterans with a service-connected disability of 10% or more will be placed at the top of the best qualified group. The best qualified group is the first to be referred to the hiring facility for further consideration and possible interview. The remaining groups may be referred based on the number of applicants available.
VA offers a comprehensive benefits package. This link provides an overview of the benefits currently offered:
The Federal Government has special appointing authorities for persons with qualifying disabilities (go to
). For additional information on these, and other special appointing authorities, refer to this
or contact the hiring Human Resources Management Service
at: 5000 West National Avenue
Milwaukee, WI 53295
Veterans and Transitioning Service Members:
Please visit the
VA for Vets
site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
Interagency Career Transition Assistance Plan
Career Transition Assistance Plan
(CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified (have a final rating of 85 or more) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at
VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.
This job opportunity announcement may be used to fill additional vacancies.
You may be required to serve a probationary period.
The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. It is...