Contact Representative

Health Benefits Unit 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, and the cost recovery aspects of this position have a direct impact on the reimbursement of the facility.

Responsibilities

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 :

Consult Coordination / New Enrollment Appointment Request (NEAR) List :

Customer Service :

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

Position Description / PD# : Contact Representative / PD92689-A 92690-A

Requirements Conditions of Employment :

You must be a U.S. Citizen to apply for this job. Selective Service Registration is required for males born after 12 / 31 / 1959.

You may be required to serve a probationary / trial period.

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.

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).

Qualifications :

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08 / 28 / 2025.

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-07 position, you must have served 52 weeks at the GS-06.

For a GS-06 position, you must have served 52 weeks at the GS-05.

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 Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.

Applicants must be eligible under the VA Interchange Agreement, having served continuously for at least one year in the other merit system under this interchange agreement.

All Title 38 Veterans Canteen Service (VCS) employees must have served in their Excepted Service position for at least 90 days in order to be eligible for a position within the Competitive Service.

Applicants who were previously selected under a Competitive Delegating Examining Unit (DEU) announcement must have served in their position for at least 90 days prior to being eligible for other positions within the Competitive Service.

You may qualify based on your experience as described below :

Specialized Experience :

GS-07 : You must have one year of specialized experience equivalent to at least the next lower grade GS-06 in the normal line of progression for the occupation in the organization.

GS-06 : You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but is not limited to :

You will be rated on the following Competencies for this position :

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