Claims Assistant

Summary This position is located in the Benefits and Enrollment Section of the Business Office within the Iowa City VA Health Care System in Iowa City, IA. The primary purpose of this position is to help determine Veterans eligibility and entitlement for health care services in the VA system. Learn more about this agency Duties ***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** MAJOR DUTIES: Interviews and counsels' patients applying for outpatient and inpatient medical care. Assists patients with completion of the means test (financial assessment) process. Provides information to applicants or inquirers regarding VA medical care eligibility and entitlement requirements. Screens applicants for humanitarian emergencies, possible third party and workmen's compensation cases. Reviews all lodging requests. Processes admissions accurately and timely, determining bed availability according to policy and entering required information into the appropriate system. Maintains an electronic log of patients reporting to the Patient Registration window requesting services. Resolves problems and complaints involving procedural administrative issues. Provides guidance to the medical staff regarding administrative procedures, legal eligibility and entitlement of applicants. Adjusts workload assignments by coordinating with other co-workers in immediate work area. Assists and processes long term care applications, hardship cases and/or other special cases. Performs other related duties as assigned. Work Schedule: Monday - Friday, 7:30 am - 4:00 pm or 8:00 am - 4:30 pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not approved Requirements Conditions of employment 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. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work requires minimal physical effort and mainly office work, such as standing, walking, bending, sitting, talking on telephone and typing. 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 dentification 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) - See "Required Documents" below for details. 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, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications EXPERIENCE: You must have one (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service that equipped you with the knowledge, skills, and abilities to successfully perform the duties of this position. Specialized experience includes: utilizing computer systems and automated databases to process claims, applications, enrollments, or eligibility determinations; reviewing forms and records for accuracy and completeness; communicating with customers, applicants, or beneficiaries in person and by telephone to obtain information and/or resolve issues; maintaining and retrieving medical, administrative, or case records; and using office equipment and standard software applications to support administrative and/or claims-related functions. EDUCATION SUBSTITUTION (TRANSCRIPTS REQUIRED): Successful completion of 4 years of education above high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must be obtained in an accredited business, secretarial or technical school, junior college, college or university. If you are qualifying on education, transcripts are required. OR COMBINATION (TRANSCRIPTS REQUIRED): An equivalent combination of specialized experience and post-high-school education as described above that demonstrates your ability to perform the duties of this position. Only education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable towards meeting the specialized experience requirement. If you are qualifying with a combination of experience and education, your experience must be detailed in your resume and transcripts are required. 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 IMPORTANT: 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 Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. 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. 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. The Interagency Career Transition Assistance Plan (ICTAP) and 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 and be found well-qualified (have a final rating of 80 or more before any Veterans preference points) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. Expand Hide  additional information Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.