Health Benefits Assistant

Full Job Description

This position is located in the Veterans Health Administration (VHA) at the San Diego VA Medical Center (VAMC) in the Health Administration Service (HAS).

The primary purpose of the Health Benefits Specialist is to perform a variety of duties pertaining to enrollment, eligibility verification, health benefits, Financial Assessments (Means Test), and the revenue programs.

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 02/02/2026.

You may qualify based on your experience and/or education as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: obtaining and processing enrollment documentation, updating demographics, establishing eligibility of Veterans for health benefits; provides an explanation of VA Health Benefits and reimbursement information on all patients requesting care within the VA San Diego Healthcare System (VASDHS).

OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have four years of education above the high school level.

OR, Combination: Applicants may also combine education and experience to qualify at this level.

You must have an combination of specialized experience and education beyond the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement.

One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience.

You will be rated on the following Competencies for this position: Information Assurance Interpersonal Skills Problem Solving 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 sedentary; typically, the employee sits comfortably to do the work.

However, there may be some walking, standing, bending, carrying of light items such as papers, book, small parts, or driving and automobile, etc.

No special physical demands are required to perform the work.

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/.

Major Duties:

The duties of a Health Benefits Specialist include but are not limited to: Receive and processes documents and reports in accordance with established procedures.

Review documents and reports for completeness and enters pertinent information into an automated tracking system.

Evaluate documents, such as enrollment applications, Means Tests and other data collection forms. Maintain automated systems to track suspense's.

Utilize computer terminals or personal computers to make inquiries, enter data, correct data, to perform analysis of data and generate a variety of reports.

Make or assist in making the determination as to the patients' eligibility for benefits. Assist in determining the medical care benefits to which the patient has entitlement.

Respond to routine technical questions regarding patient rights and responsibilities and medical eligibility for care.

Interpret admission and outpatient policies to patients, their families, agency employees, and veteran's organizations. Collaborate in a team-oriented, customer-driven, environment.

Demonstrate flexibility, integrity and accountability with work ethic.

Enhance customer experience with positive human interactions and therapeutic alliances, and promote the coordination, continuity and integration of care.

Work Schedule: Monday - Friday 7:00am-4:30pm Virtual: This is not a virtual position.

Position Description/PD#: Health Benefits Assistant/PD11194A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized