Health Benefits Assistant

Health Benefits Assistant

Summary As Health Benefits Assistant for Health Administration Service at the New Mexico VAMC (NMVAMC), the incumbents provide a high level of administrative and data support to the HAS to include the Community Based Outpatient Clinics (CBOCS) as well as to the NMVAMC. Complete all application requirements detailed in the Required Documents section of this announcement. Responsibilities Duties include but are not limited to :

• Serve as advisors and experts to the HAS Section Chiefs and support the management information components of all health eligibility related programs.
• Entering data and information, when necessary, but also reviewing reports, records and statistical computations for accuracy and propriety.
• Review, verify, and analyze data submitted for consistency with financial and program objectives, and adherence to VA directives.
• Assist the Public Affairs Office as well as other Services at Phoenix VAMC with community activities such as Health Fairs, Homeless Veterans Stand Downs, Post Deployment Health Re-assessment (PDHRA) and Tribal Community Outreach programs.
• Interview patients applying for medical benefits. Verify eligibility / entitlement for benefits of all applicants using various methods including income assessments, military discharge documents, Veterans Information Solution (VIS), Enrollment System Redesign (ESR) and other means such as communications with VA Regional Office, VA Records Processing Centers and HEC Health Eligibility Center.
• Review various financial documents to include tax forms, bank records, and SSI / SSDI forms.
• Advise the veterans of their entitlement to various medical benefits and discusses co-payment requirements of veterans in discretionary categories. Extreme tact, diplomacy and privacy are required to explain complicated laws in this area.
• Extensive knowledge of the Medical Center and policies is required to respond to inquiries from veterans, Medical Center staff and other agencies regarding applying for care, eligibility, and Beneficiary Travel, etc.
• Ensure proper identification is utilized when processing the Veterans card according to national guidance.
• Monitor 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.
• Provide exceptional customer service by exceeding the customer's expectations.

Work Schedule : Monday - Friday, 07 : 30am-04 : 00pm (Supervisor's Discretion) Virtual : This is not a virtual position.

Position Description / PD# : Health Benefits Assistant / PD13111A Financial Disclosure Report : Not required

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 Subject to background / security investigation Selected applicants will be required to complete an online onboarding process 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.

Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10 / 24 / 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-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.

You may qualify based on your experience as described below :

Specialized Experience : 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 are not limited to : Providing customer service to patients / veterans; performing clerical and technical work related to medical records and benefits; performing routine administrative procedures; establishing and maintaining filing and reference systems; utilization of office automation software and establishing priorities and setting deadlines; dealing with patient administration, computer systems, scanning documents, reports and participating with written and oral presentations.

Education : Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have four years of education above the high school level obtained in an accredited business, secretarial or technical school, junior college, college or university.

OR, Combination : Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond two years of education above the high school level. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide your semester hours of education beyond two years (total semester hours minus 60) by 60. Add the two percentages. To qualify for this position as the computed percentage of the requirements must be at least 100%.

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

Attention to Detail, Clerical, Customer Service, and Flexibility

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.

Physical Requirements : This is primarily a sedentary position, but the work requires some walking, bending, stooping, lifting, and carrying objects such as manuals, documents, etc. The position requires constant viewing of a computer. Concentration and sustained performance under prolonged stress is required because of the time factors involved in completion of work assignments within deadlines. Occasionally veterans may be angry and potentially violent.

For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https : / / www.opm.gov / policy-data-oversight / classification-qualifications / general-schedule-qualification-standards / .

Education A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note : Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here : http : / / ope.ed.gov / accreditation / .

If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit : https : / / sites.ed.gov / international / recognition-of-foreign-qualifications / .

Additional Information Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration / Operations, Security, and Preparedness (HRA / OSP) at The Fair Chance Act.

Participation in the seasonal influenza program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service.

HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities.

HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform