Lead Medical Support Assistant (Eligibility)

at Veterans Affairs, Veterans Health Administration in Hines, Illinois, United States

Job Description

Summary The incumbent serves as the Lead AMSA for Enrollment & Eligibility Department within PAS. The incumbents working knowledge of various policies and procedures relating to the business rules regarding the enrollment processes and procedures, as well as the multiple electronic systems and software programs utilized within the team to ensure the proper flow of work within the team. The ideal candidate will have 1 year of experience using eligibility policy, processes and systems. Responsibilities Major Duties: Experience using eligibility policy, processes and systems. Provides educational sessions to train new employees in Clerical process in an efficient and effective manner to ensure that clerical processes, functions, and goals are understood and met. Must have knowledge of VA policies, regulations, guidelines, and process as they relate to the scheduling of patient appointments, consults, NEAR, Electronic Wait Lists, and pre-appointment clinical requirements (i.e., labs, EKGs, x-rays) to ensure readiness for the patient visit. Monitors clinic’s Access to care. Monitors ICB usage ensuring insurance is collected and captured appropriately at enrollment. Must keep abreast of rapidly changing regulations, directives, software patches, programs, and processes involved in the delivery of the healthcare benefits package. Assist with the clean-up of the EARR (Encounter Action Required Report) and delinquent recall report; support clinics regarding utilization and clinic profile management i.e., set-up of clinic grids, cancel and restore clinics. Screens/receive phone calls in a courteous and timely manner, determine the nature of request and provide the information desired using privacy rules and established clinic processes. Prepares correspondence and memos as needed. Promotes Veteran registration for and utilization of My Healthy Vet (MHV). Enters Veterans seeking emergent/urgent care, scheduling appointments accurately. Utilizes call lists and telephones Veterans to pre-register them before their scheduled visits. Incumbent updates all patient demographics. Communicates and interacts with patients in a manner which is appropriate to cognitive, emotional, and chronological maturation needs of the adult and/or geriatric patient. Assures that all appropriate VA forms are used correctly, and regulations followed. The incumbent oversees the status of work for all lower grade MSA positions working in the various clinical services making day-to-day adjustments in accordance with established priorities, obtaining assistance from the supervisor on problems that may arise, such as backlogs which cannot be disposed of promptly. Able to resolve workplace issues, simple informational complaints of employees, referring other to supervisor for resolution. Incumbent will conduct ongoing audits to ensure quality of work for accurate and timely scheduling of appointments. Recognizes and refers substandard performance or substandard behavior to supervisor as needed. Provides information and/or makes recommendations to supervisor on MSA performance, behavior. Identifies education and training needs of staff and evaluating scheduling practices. Makes recommendation for reassignments, recognition for outstanding performance and other personnel needs. Orienting and providing on the job training for new and current employees. As a front-line contact with patients and staff, in the scheduling role, the incumbent sets the tone for perception concerning quality of healthcare services at the VA and will show a high degree of tact and diplomacy when dealing with Veterans who have multiple health problems and who may be frustrated with the administrative process associated with diagnosis and treatment. The incumbent supports patient safety standards using appropriate standards of identification. validation i.e., two forms of identification, name, and full Social Security Number. The incumbent must ensure preregistration is completed and collects, scans, and updates health insurance information serving a major role in the revenue process. Will also possess superb telephone etiquette utilizing the standardized telephone greeting while ensuring other frontline staff is as well. This incumbent must have the ability to learn the technical competency in the use of BMS, VistA, VSE, CPRS, ICB Scanners, Vet-link, Kiosks, HIN, VAR and MHV. Must provide excellent customer service and have an advanced understanding of medical terminology, medical administrative practices, patient consult processes, patient scheduling procedures, medical record system, Privacy Act, HIPP A rules and the Freedom Act as they relate to the handling of confidential and sensitive patient information. Incumbent must be a proficient computer operator who is able to learn, understand, and monitor department specific software programs. Must also be knowledgeable in Microsoft Office programs such as Word, Excel, PowerPoint, and Outlook; proficient in gathering, analyzing, and reporting data as it relates to inpatient units and outpatient clinic operations. Work Schedule: Monday-Friday 8:00am – 4:30pm Telework: Not Suitable Virtual: This is not a virtual position. Functional Statement #: 578-00056-F Relocation/Recruitment Incentives: Not Authorized. Financial Disclosure Report: Not required. Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job. You must be a current Hines VHA employee. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. You may be required to serve a probationary period. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Must pass pre-employment evaluation. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Current, Permanent VA Employees must upload a copy of the most recent 2024 SF-50 (that is not for an award), indicating current VA employment. Qualifications To qualify for this position, applicants must meet all requirements on the closing date of this announcement. The ideal candidate will have 1 year of experience using eligibility policy, processes and systems. Incumbent must possess knowledge of clinic processes and service in order to interact with various clinic staff members. This employee must have working understanding of national performance measures and monitors, particularly in relation to no-shows, appointment cancellations, new patient scheduling, consult management and management of returning patients. Maintains current knowledge of procedures, policies, guidelines, etc. to be able to answer questions or obtain needed information to make an informed decision. Incumbent complies with all mandatory requirements regarding the scheduling process in order to maintain scheduling access. BASIC REQUIREMENTS: Citizenship: Must be a United States Citizen. Language: Must be proficient in basic written and spoken English. EDUCATION/EXPERIENCE: Must possess six (6) months experience of clerical, office, customer service or other administrative work that indicates the ability to acquire the knowledge and skill necessary to perform the duties of the Medical Support Assistant. OR Must have successfully completed one (1) year above high school. This education must have been obtained in an accredited technical school, junior college, college, or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university. OR Equivalent combinations of experience and education are qualifying for entry level. IN ADDITION TO MEETING THE BASIC REQUIREMENTS LISTED ABOVE, YOU MUST MEET THE GRADE REQUIREMENTS AT THE GS-7 LEVEL TO QUALIFY FOR THIS POSITION. GS-7 LEVEL GRADE REQUIREMENTS: Must have one (1) year of experience that is directly related to the duties of a