Responsible for overseeing the functions of the MCCF program related to third party insurance verification, demographic and insurance.  Responsible for developing, analyzing, evaluating, and advising on improving the effectiveness and efficiency of work methods, procedures, distribution of work, and information/documentation accountability for the Insurance/Check-in/Pre-Registration Section.

 

 

Back to top   Duties

 Additional Duty Location Info: 

1 vacancy - San Diego County, CA



Responsible for overseeing the functions of the MCCF program related to third party insurance verification, demographic and insurance.  Responsible for developing, analyzing, evaluating, and advising on improving the effectiveness and efficiency of work methods, procedures, distribution of work, and information/documentation accountability for the Insurance/Check-in/Pre-Registration Section.  Provides on-the-job-training in accordance with established procedures and practices in the MCCF program.  Verifies insurance benefits on a semi-annual basis for all active patients including detailed benefits for inpatient care, outpatient encounters, psychiatric, chemical dependency, prescription coverage, insurance plan and subscriber information, plan coverage limitations, and pre-existing conditions.  Devises action plans for effective and efficient ways to develop, evaluate, and issue program policy guidance pertaining to veteran health insurance for reimbursement.  Performs work that involves the collection, compilation, and/or tracking of data and statistical information.  Assists in planning, reviewing, and reporting on data/statistical results of program/project studies. Prepares responses to inquiries from insurance companies and other agencies, government organizations and veteran's interests groups on various aspects of insurance programs.  Investigates and gathers information to inquiries from policyholders, local program officials, etc.  Counsels veterans on coverage and the need for information to ensure VA receives maximum reimbursement for services. 


 

Back to top   Qualifications and EvaluationsQUALIFICATIONS REQUIRED: 


One (1) year of specialized experience, equivalent to the next lower grade level, that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. 


MUST TYPE 40 WORDS PER MINUTE AND THIS MUST BE ANNOTATED ON THE APPLICATION OR RESUME.


TIME-IN-GRADE REQUIREMENT: 

GS-06: One (1) year at or equivalent to the next lower grade level.

You will need to successfully complete a background security investigation before you can be appointed into this position.

Applicants for this position must pass a pre-employment medical examination. HOW YOU WILL BE EVALUATED:


Qualified applicants may be evaluated on knowledge, skills, abilities, and other factors as measured by the following job-related elements: 


1.      Knowledge of VA regulations, policies and procedures related to MCCF insurance 

functions and/or functions related to insurance benefits and eligibility.

2.  Knowledge of Insurance Programs and the procedures for reimbursement of third party insurance.

3.  Ability to plan work, set priorities and establish time frames for the staff.

4.  Ability to communicate orally and in writing.

5.  Ability to deal effectively with people from various backgrounds.

6.  Ability to apply laws and regulations on the confidentiality of health information (e.g. Privacy Act, Freedom of Information Act).

 

Back to top   Benefits and Other Info BENEFITS: 

You may participate in the Federal Employees Health Benefits program, with costs shared with your employer. More info: http://www.usajobs.gov/jobextrainfo.asp#FEHB.

Life insurance coverage is provided. More info: http://www.usajobs.gov/jobextrainfo.asp#life

Long-Term Care Insurance is offered and carries into your retirement. More info: http://www.usajobs.gov/jobextrainfo.asp#ltci

New employees are automatically covered by the Federal Employees Retirement System (FERS). If you are transferring from another agency and covered by CSRS, you may continue in this program. More info: http://www.usajobs.gov/jobextrainfo.asp#retr

You will earn annual vacation leave. More info: http://www.usajobs.gov/jobextrainfo.asp#VACA

You will earn sick leave. More info: http://www.usajobs.gov/jobextrainfo.asp#SKLV

You will be paid for federal holidays that fall within your regularly scheduled tour of duty. More info: http://www.usajobs.gov/jobextrainfo.asp#HOLI

Opportunities are available in numerous locations and employees may transfer to new locations to further their career goals.

If you use public transportation, part of your transportation costs may be subsidized. Our human resources office can provide additional information on how this program is run.

Qualified federal employees may be covered by our child care subsidy program or dependent care flexible spending account. Our human resources office can provide additional information on eligibility. More info: http://www.usajobs.gov/jobextrainfo.asp#CCRS

You can use Health Care Flexible Spending Accounts for expenses that are tax-deductible, but not reimbursed by any other source, including out-of-pocket expenses and non-covered benefits under their FEHB plans. More Info: http://www.usajobs.gov/jobextrainfo.asp#FSAOTHER INFORMATION: 

The materials you send with your application will not be returned.

PLEASE DO NOT FAX, EMAIL OR SUBMIT ONLINE. 

 

Back to top   How To Apply HOW TO APPLY: 

You must submit your application so that it will be received by the closing date of the announcement.


  Applications will be accepted for posted announcements only, and must

 be received by 4:00 PM on the closing date of the announcement.  The application

 must contain the position title, corresponding announcement number, signature,

 and date.  Applicants must meet all eligibility and qualification requirements as of

 the closing date of the announcement.  Documents required by these instructions

 and in the announcement must be submitted by the closing date.  Applications and

 any attached material will not be returned.  Do not submit original documents that

 you may need in the future.  Mail application to:

VA San Diego Healthcare System 


Human Resources Management Service (05)

3350 La Jolla Village Drive
San Diego, CA  92161


 

Call (858) 552-8585 ext. 3401 for additional information.  Applications sent in government-metered envelopes or sent by electronic transmission (fax) will not be processed. 


OF-612 (or resume); DD-214 (if applicable); SF-50 (if applicable); & Disability Letter if applicable.AGENCY CONTACT INFO: 

 

 Human Resources Office Phone: 858-552-8585 x3401 Email: vasdhsjobs@san-diego.va.govAgency Information:Department Of Veterans Affairs Department of Veterans Affairs 3350 La Jolla Village Drive San Diego, CA 92161 US WHAT TO EXPECT NEXT: 

You will be notified by mail.

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