Medical Support Assistant (Advanced) - Enrollment/Eligibility & Registration

The Advanced Medical Support Assistant (MSA) serves in the Enrollment and Eligibility Department. The position is highly technical in nature as it's the primary gateway for all Veterans seeking care or other benefits across the VA Health Care System (VAHCS). The primary duty of this position is to perform tasks that determine Veteran's health eligibility, identifies copay requirements based on Priority Group assignment and Means Testing.

Total Rewards of a Allied Health Professional Incumbent will serve as technical expert providing enrollment and eligibility guidance to service and facility leadership. He/she supports the management information components of all health eligibility related programs within the HCS. This includes not only entering data and information, when necessary, but also analyzing reports, records, and statistical computations for accuracy and propriety.

Local input is compared with the Health Eligibility Center (HEC) in Atlanta, GA and will affect data entry for encounter entries that go to Austin for workload credit. The incumbent must review the Incomplete Encounter Management Module (IEMM) report to clean up any discrepancies in administrative or registration data that would prevent the transmission of encounters. This includes, but is not limited to, missing elements from registration, missing period of service, conflict in information, Z07 inconsistencies 405 error, county code missing, etc.

The incumbent must be proficient in utilizing other eligibility software such as the Hospital Inquiry (HINQ), Veterans Information System (VIS), Defense Personnel Records Information Retrieval System (DPRIS), Veterans Benefits Management System (VBMS), Enrollment System (ES), and Computerized Patient Record System (CPRS) to appropriately enroll eligible beneficiaries for health care benefits. Significant skill in using mathematical equations to accurately compute income assessments, etc.

Knowledge of beneficiary travel rules and regulations regarding legal entitlement to travel reimbursement sufficient to explain individual eligibility, copays and to help with submission of a travel claim for reimbursement of expenses. He/she must assist with clinic access contingency plans by adjusting appointment times, location, or dates as well as shift patients to other healthcare providers as conflict with staffing and/or coverage occurs.

Incumbent must screen/receive phone calls in a courteous and timely manner, determine the nature of requests and provide the information desired using privacy rules and established clinic processes. A caring, compassionate, and sensitive manner is essential when explaining procedures to veterans and their family members both in person and on the phone. The AMSA can independently manage position responsibilities with little supervision as well as set priorities and deadlines adjusting the flow and sequencing of the work to meet team and patient needs.

The AMSA participates in the daily team huddles and weekly team meetings where patient care planning and management occur, except during staff shortages for coverage. Work Schedule: Monday to Friday 8:00 am to 4:45 pm Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Pay: Competitive salary and regular salary increases. Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.

Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child. Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66. Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: AdHoc Telework Available Virtual: This is not a virtual position.

Functional Statement #: Medical Support Assistant (Advanced) Eligibility/Enrollment & Registration Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized

Basic Requirements: Citizenship: Be a citizen of the United States (U.S.). Non-citizens may be appointed when it is not possible to recruit qualified citizens according to 38 U.S.C. § 7407(a). Experience. None. Education. High school diploma, General Education Development equivalency certificate, or proficiency certificate from a State or territorial-level Board or Department of Education. Licensure/Certification/Registration.

None. Foreign Education. To be creditable, education completed outside the U.S. must be deemed at least equivalent to that gained in a conventional U.S. program by a private organization specializing in the interpretation of foreign educational credentials. English Language Proficiency. Candidates must be proficient in spoken and written English in accordance with 38 U.S.C. § 7403(f). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

GS-6 Grade Determination. In addition to the basic requirements for employment, candidates must meet the following: Experience. One year of creditable experience equivalent to the next lower grade (GS-5). Experience includes duties related to the delivery of health care services in an inpatient or outpatient setting. Advises clinical staff on current administrative processes. The MSA is responsible for answering phones, greeting patients, relaying messages to appropriate staff inside or outside of the unit, and scheduling appointments, including interpreting and verifying provider orders in accordance with VHA national scheduling guidelines.

Assignments at this level include, but are not limited to: scheduling, canceling, re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources; participating in huddles with other MSAs and/or clinic staff to determine the daily needs of the clinic, monitoring both inpatient and outpatient appointments in areas of responsibility; verifying and updating demographics and insurance information when patients check-in for appointments.

Coordinates administrative functions relating to emergency and non-emergency transfers to other VA facilities or private hospitals and determines appointment type based on the patient's eligibility status (i.e., TRICARE, sharing agreements, collaterals, research patient, VA employee, etc.). Knowledge, Skills, and Abilities: In addition to the experience above, the candidate must demonstrate the following KSAs: Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care.

Knowledge of health care facilities, assist patients during registration and enrollment process, to gather and complete military service paperwork. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g., medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.

Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns.

Assignment. For all assignments above the FPL, the higher-level duties must be of significant scope, administrative independence, complexity, and range of variety as described in this standard at the specified grade level and be performed by the incumbent at least 25% of the time. At the advanced level, the Medical Support Assistant (Advanced) (AMSA) performs difficult and responsible specialized and expert administrative patient support while working collaboratively in an interdisciplinary coordinated care delivery model.

Work involves specialized administrative judgment and the flexible use of a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or care in the community resources. Recommend changes to existing clinic procedures based on current administrative guidelines. Expertise in utilizing numerous advanced patient systems in support of multiple clinics involved in an interdisciplinary coordinated care delivery model.

Coordinates with the patient care team to review clinic appointment availability (utilization) to ensure that clinic schedules are closely monitored to effectively support the needs of the clinics, and makes adjustments as necessary. MSAs at this level develop and/or maintain effective and efficient communication with the patient, interdisciplinary coordinated care delivery model teams, VA medical centers, and other agencies (e.g., assist with communications during the inpatient to outpatient discharge; communicate with non-VA medical facilities; prepare correspondence to notify patients of normal lab results; manage a system for follow-up care such as consults, tests, etc.).

Other assignments at this level include, but are not limited to: processes incoming patient secure messaging through MyHealthyVet and coordinates with care team as appropriate; participates in team huddles and team meetings to manage, plan, problem solve, and follow-up with patient care by sharing information and collaborating with the interdisciplinary team; setting priorities and deadlines, adjusting the flow and sequencing of the work to meet team and patient needs; identifies incomplete encounters and communicates findings to providers; as needed; assists the team to reinforce the plan of care and self-help solutions; enters appropriate information into the electronic record; monitors pre-appointment information and/or requirements to assure readiness for patient visit/procedure; manages patient systems to verify and validate accuracy and resolve issues; evaluates patient information and clinic schedule lists to determine whether the patient requires an immediate appointment; informs team members about shared patients (i.e., those who receive their care at multiple VA centers or those who receive care in the community).

Preferred Experience: Customer Service with experience in deescalation, problem solving, decision making and good tactful communication skills orally and in writing Advanced knowledge of managing a clinic to include advanced knowledge of policies and procedures associated with operational activities and team collaboration Advanced Knowledge of Medical Terminology including documenting/reading administrative notes in medical charts Scheduling/rescheduling in a clinical setting including experience reading and verifying provider's orders, consults, imaging requests and laboratory orders Experience with workload reports and data collection (MS Excel) to include meeting deadlines, set priorities and organize the work Demographics verify and update along with third party insurance capture including providing proper information to patients and family members Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

The full performance level of this vacancy is GS-6. Physical Requirements: Physical aspects associated with work required of this assignment are typical for the occupation and would generally not require a pre-placement examination.