Health Benefits Assistant

Full Job Description

The position is assigned to the Business Office of the Eastern Oklahoma Health Care System and performs a broad range of administrative duties to support Veteran Benefits and registration and intake activities within the Medical Center.

This includes supporting the business unit that administers health and related benefits within an integrated system of VA health care resources and health care access points.

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/26/2026.

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: 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: Comprehensive knowledge of pertinent laws, federal regulations, polices guidelines, directives, and handbooks.

Comprehensive knowledge of Healthcare System memorandums, administrative procedures and processes, standard operating procedures, internal policies, and other guidance related to such areas as eligibility for medical benefits, outpatient programs, patient scheduling, admissions and discharges, patient transfers, healthcare network capabilities for patient referrals and transfers, employee health, beneficiary travel, inpatient and outpatient statistical reporting, and others related Medical Center organization and administration.; Knowledge of the Privacy Act, the Freedom of Information Act, HIPPA guidelines, and other authorities with respect to release of information and established guidelines to preserve the confidentiality of record contents.

Extensive knowledge of the organizational and interdepartmental relationships of an active Medical Center to effectively relay the medical benefits package to all inquiring parties.

Comprehensive knowledge and the ability to use several computer systems, and varied functions of computer spreadsheets, database computer applications, etc.

to produce and maintain a wide variety of documents. Ability to participate in studies which may require statistical measurement, data analysis, and report preparation using databases and dashboards.

Prepares reports as required and makes reasonable recommendations for system or process improvement. 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 beyond the high school level. Note: (TRANSCRIPTS REQUIRED).

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 high school level in excess of 60 credits.

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:

Major duties of this position include, but are not limited to: Performs technical activities involved with screening, processing, and assisting Veterans, non-Veterans, and beneficiaries seeking multiple medical treatment benefits.

Assists MSA staff with loading VA Registry exam requests and traveling Veterans into database upon check in.

Advising applicants of the health benefits to which they are legally entitled; responding to technical questions regarding Veterans administrative rights and situational eligibility for healthcare; and providing Veterans with administrative advice and guidance.

Provides information regarding benefits to Veterans and responds to complex questions involving regulations and/or beneficiary entitlement.

Communicates results to patients, families, agency employees, and Veterans organizations.

Provides follow up with the PCMM coordinator for assignment to the Primary Care team after initial appointment is scheduled.

Works with Veterans Health Information Systems Technology enrollment software.

Monitors enrolled patient database information to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs.

Facilitates receipt of all VA & Non-VA medical records to support indexing of records to records system; ensures records are available for review upon vesting appointment.

Reviews and processes VA healthcare eligibility in conjunction with Department of Defense (DoD) Sharing Agreements (TriCare & CHAMPVA) to determine eligibility for VA health care referencing multiple sources, such as the Health Eligibility Center (HEC), VIS, and or/military discharge papers to assign a priority group to the Veteran.

Reviews and processes new and recurring applications (paper, in-person, and electronic) for medical care (e.g., Dental, Behavioral Health, Geriatrics and Extended Care, Diagnostic and Therapeutic, etc.) through applying the appropriate regulatory authority to each program.

Processes re-enrollment into the system and assists Veterans in changing facilities if necessary.

Work Schedule: Full Time, Monday through Friday, 8:00 am to 4:30 pm Virtual: This is not a virtual position.

Position Description/PD#: Health Benefits Assistant/PD14665A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized