Health Benefits Assistant

Summary This position description is for a Health Benefits Assistant (HBA), located within the Health Benefits section of Wilkes Barre VA Medical Center. The HBA is responsible to provide a high level of administrative and data support to the department in all matters health benefits related to include the Community Based Outpatient Clinics (CBOCs). Responsibilities The Health Benefit Assistant (HBA) must be familiar with all functions of admitting, scheduling, registration, travel allowance, eligibility and enrollment determinations, release of information, medical records, compensation and pension, patient transportation, Veterans Health Identification Card, and the service programs. HBAs will provide the utmost customer service to customers, both internal and external by upholding the ICARE Values definitions at all times. Duties included but not limited to: Subject matter expert for the Health Benefits section of the Business office 70%The HBA serves as a subject matter expert for the Health Benefits section of the Business office to screen, advise, technical assistance, and assist Veterans and other beneficiaries seeking and receiving medical treatment. Incumbent provides advice, problem resolution, and administrative support for all related healthcare services. Responsible to ensure accurate, timely and consistent information is entered into the appropriate database. The incumbent registers, schedules and prepares all pertinent data for all admissions by ensuring that all documentation is completed and signed by the admitting physician. Administratively processes patients for pre-admission and admission to the Medical Center and/or Community Living Center (CLC) including unit assignments, review and assurance that medical records are complete and correct, necessary documentation is available and updated, and patient is properly identified. Responsible for scanning all medical documents received and ICB scanning 10%The HBA is responsible for scanning all medical documentation into the Computerized Patient Record System (CPRS) to ensure patient safety and patient quality of care. The incumbent follows directives and policies on scanning appropriate documentation into the Veterans medical record. Coordinates with scanning department should any issues or concerns arise on medical documentation scanning procedures. Process Beneficiary travel requests and Special Mode Transportation requests 10%The HBA processes request for travel pay, entering data into VISTA and/or completing appropriate travel claim forms. Advises Veterans on eligibility/ineligibility to receive travel pay upon request utilizing VHA directives and polices concerning beneficiary travel. Incumbent provides administrative guidance on Special Mode request to the medical team and ensures requests are in compliance with all VHA directives and policies. Conducts personal interviews with Veterans and/or their family or representative 5% The HBA conducts personal interviews with the Veteran and/or their family or representative to obtain additional assistance in establishing eligibility when the normal method is unsuccessful and the Veteran is seeking emergent medical care and has not been enrolled in the VA Health Care System. Responsible for requesting logistic and administrative supplies 5%The HBA tracks and requests administrative supplies such as printer cartridges, paper, pens, wristbands, and any other request that is requested from the team. Incumbent will request work orders through the Supervisor, track when action has been completed and follow up with staff to ensure issue has been resolved. Work Schedule: Monday-Friday 12:00 p.m.-8:30pm Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Assistant/PD00433A 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. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work is primarily a sedentary position. There may be some walking, standing, bending, carrying of light items such as papers, books, small items, etc. No special physical demands are required to perform the work. Concentration and sustained performance under potential stress of accuracy and deadlines is required because of factors involved in completion of various complex work assignments. 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 identification 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) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial 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 period, your employment will be terminated unless you receive certification, in writing, that 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, 11/06/2026. 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-05 position you must have served 52 weeks at the GS-04. 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 and/or education as described below: For Specialized Experience at GS-05: At least one (1) full year of specialized experience, which equips you with the particular knowledge, skills, and abilities to perform successfully the duties of the Health Benefits Assistant, GS-05 position, and that is typically in or related to the work of the position to be filled. To be creditable, this specialized experience must have been equivalent to the GS-04 grade level in Federal service to qualify at the grade 05.Examples of specialized experience include:1) Providing positive, upbeat, customer service while interacting with patients and hospital staff2) Updating and verifying demographic information3) Creating electronic medical files4) Utilization of Microsoft Word, Microsoft Excel and Outlook to complete work assignments5) Providing administrative support: filing, answering phones, greeting customers, misc. office work. OR GS-05: Substitution of Education for Experience (TRANSCRIPTS REQUIRED): Do you possess Four (4) years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or 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 at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. OR GS-05: Combination of Education and Experience (TRANSCRIPTS REQUIED): Do you possess a combination of successfully completed education and experience to meet the total experience requirements. (i.e. 6 months of specialized experience and 3 years of education above the high school level). NOTE: Only education beyond the second year can be used in combination with specialized experience to qualify for this grade. 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. 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. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. 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.