This position is located in a Consolidated Patient Account Center (CPAC) in the organization of the Deputy Director of Operations serving as the Facility Revenue Manager (FRM) located on-site at a medical facility. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by consolidation of billing and collection activity supported by medical center based utilization review, data validation and customer service functions.
1. Monitor changes in Veteran eligibility that support the need to reset medications based on new SC/SA and/or means test changes where the Veteran is no longer medication co- payment required.
2. Monitors that Veterans are credited for prescriptions filled at facilities for the purpose of the yearly co-payment cap by completing the Push Rx Copay Cap transaction.
3. Monitors Held Charges and Days on Hold to ensure that co-payments are released timely and appropriately.
4. Develops and provides monthly reports to the Health Information Management (HIM) Chiefs -Business Office Manager (or comparable position), Compliance.
5. Monitors the closing and creation, set-up, naming conventions and stop code assignments of new clinics within a facility and determines their designation as High Dollar such as surgeries, chemotherapy, dialysis, etc.
6. Reviews clinical information and obtains third-party insurer authorization for continuation of care and payment.
7. Keeps abreast of clinical activities that have the potential to negatively affect revenue.
Work Schedule: 40 hrs per week; Monday-Friday; Tour of Duty to be set based on organizational need.
Telework: Authorized after successful completion of training, supervisory approval, and agency policy.
Virtual: This is not a virtual position.
Position Description/PD#: Financial Management Specialist/PD57798A
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Financial Disclosure Report: Not required
Job family (Series)
0501 Financial Administration And Program
- Financial Specialists, All Other
- Specialists, Financial, All Other
Conditions of Employment
- You must be a U.S. Citizen to apply for this job
- Designated and/or random drug testing may be required
- Selective Service Registration is required for males born after 12/31/1959
- 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
QualificationsTo qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/28/2021.
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-11 position you must have served 52 weeks at the GS-09. 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:
- GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
- Evaluating facility revenue programs using qualitative and quantitative analytical methodologies sufficient to analyze trends.
- Skill applying the Code of Federal Regulations, OCC, PMO, Medical Center, and Fiscal policies and procedures as well as VA Directives pertaining to Release of Medical Information, Revenue Program, Eligibility, and HIPAA regulations.
- Skill applying medical terminology and procedures common to specialty services to document billing instruments, make appropriate entries in DHCP and various other operating programs, and to deal effectively with clinical staff, patients, and health insurance carriers.
- Skill processing several types of billing to communicate with Patient Advocates and different government agencies such as DOD, Tricare, Champ VA, Allied Beneficiaries and Sharing Agreements on a variety of revenue-related items such as billing, revenue collections, and reimbursements.
- Analyzing information that comes from the Non- VA/Fee Program through the FBCS software to ensure reimbursement for dollars expended to pay for private-sector treatment for our Veterans.
- Proficiency using hospital wide automated systems such to generate reports, exam billing and collection data.
- Skill and ability to work under stressful situations with individuals from wide and varied backgrounds while maintaining tact and diplomacy.
- GS- 11: Substitution of Education for Experience (TRANSCRIPTS REQUIRED): Do you possess a PhD. or 3 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D?, if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work.
- GS- 11: Combination of Education and Experience(TRANSCRIPTS REQUIRED): Do you possess combinations of successfully completed graduate education and specialized experience directly related to the work of the Financial Management Specialist position, which may be used to meet the experience requirements for GS- 11 position.
You will be rated on the following Competencies for this position:
- Computer Skills
- Health Information Exchange
- Medical Information
- Technical Competence
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.
Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
Physical Requirements: The work is primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort.
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/.
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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.
VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process.
Receiving Service Credit or 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.
Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator.
The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. 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/.
Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
This job opportunity announcement may be used to fill additional vacancies.
Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document.
If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.
Narrative responses are not required at this time. If you are referred for consideration, you may be asked to submit additional job related information, which may include, but not limited to; responses to the knowledge, skills and abilities; completion of a work sample, and/or contact for an interview.Your resume and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.
Background checks and security clearance
Drug test required
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
To apply for this position, you must provide a complete Application Package which includes:
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
- Cover Letter
- DD-214/ Statement of Service
- Disability Letter (Schedule A)
- Disability Letter (VA)
- Performance Appraisal
- Professional Certification
- Proof of Marriage Status
- Separation Notice (RIF)
- SF-50/ Notification of Personnel Action
SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
- Most recent SF-50 if you are a current or former Federal employee
- An SF-50 showing 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
- Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
- Examples of appropriate SF-50's include:
- Within grade increases at the highest grade held; or
- Promotions with an effective date more than one year old; or
- SF-50's at the highest grade held with an effective date more than one year old.
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
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.
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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.
This job is open to
Career transition (CTAP, ICTAP, RPL)
Federal employees who meet the definition of a "surplus" or "displaced" employee.
Federal employees - Competitive service
Current or former competitive service federal employees.
Individuals with disabilities
Internal to an agency
Current federal employees of this agency.
Individuals eligible under a special authority not listed above, but defined in the federal hiring regulations.
Clarification from the agency
Open to Status Eligible (i.e. Current Veterans Administration employees, Current federal employees, Certain Military Spouses, Reinstatement, Transfer, Veterans Employment Opportunities Act (VEOA) and Other); Non-Competitive Eligible: (Veterans Recruitment Authority (VRA), Schedule A and 30% or more disabled Veterans).