Lead Health Benefits Assistant

Full Job Description

The Lead Health Benefits Assistant serves in the Eligibility Center, Patient Enrollment & Intake Section of the Central Business Office.

Provides administrative support to designated areas, with a strong emphasis on customer service & positive communications between Central Arkansas Health Care System (CAVHS), other Medical Centers throughout the VA system and the Health Eligibility Center (HEC), located in Atlanta GA., contractors, patients, and others to resolve problems & issues.

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 04/09/2026.

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-06 position you must have served 52 weeks at the GS-05. 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 as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: Preforms knowledge of patient/customer database, used to track eligibility, enrollment status, demographic information (address, phone, emergency contact information); Prepares written documents such as correspondence, memoranda, reports, pamphlets, etc.

of a routine nature; Verifies eligibility/entitlement for benefits for all applicants using various methods; Understands medical terminology and communicates with patients that are presenting for admissions, applies policies, laws, and regulations daily; Strong computer skills and the ability to use many electronic databases for complex claim processing procedures; Strong leadership skills to serve as a team lead over a multitude of operations; Ability to carry out an organizations strategic plan, mission, vision, and values and the ability to communicate and integrate these into a diverse team setting.

Familiar with VA technical laws and policies regarding healthcare benefits; Use of computer systems and Microsoft office products such as word, excel, PDF, ETC.

You will be rated on the following Competencies for this position: Technical Competence Customer Service Computer Skills Attention to Detail Leadership 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 and involves walking, bending, working at a computer and occasionally lifting of small boxes of brochures and forms.

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 include, but not limited to: Answer inquiries in person and via telephone from patients and/or families regarding eligibility for care, enrollment status, admissions, and admissions.

Serve as point of contact for clinical staff regarding eligibility and/or enrollment of patients.

Interview individuals to obtain information to determine eligibility and legal entitlement for healthcare.

Interpret and apply policies, regulations, and laws to insure Veterans meet eligibility requirements for benefits.

Advise individuals and their beneficiaries or representatives of financial obligations, co-pay requirements, and their rights to appeal. Resolve complex eligibility, co-pay, or insurance questions.

Address a variety of benefits and/or obligations (medical benefits, co-pay requirements, medication benefits, dental benefits, lodging, etc.) Maintain familiarity with public laws pertaining to Veterans benefits, state commitment laws, worker's compensation, humanitarian services, reimbursable insurance, third party billing, privacy act and release of information.

Exhibit tact and diplomacy during interactions with patients, staff, and co-workers.

Communicate in person, via telephone, via electronic mail and through shared documents with coworkers and supervisors.

Communicate with a variety of individuals including physicians, nurses, technical support staff, Veterans, and Veterans' families.

Enter information into computer system (patient registration, disposition, record tracking, appointment management, etc.) Uses multiple databases to extract data needed to make decisions on assigned work.

Processes claims for hardships, catastrophic disability, beneficiary travel deductible waivers, and visit/medication copay waivers.

Communicates with diverse populations on both routine and complex matters in urgent or emergent situations. Interprets and explains technical laws and policies addressing healthcare benefits.

Audits invoices Serves as a team lead providing guidance and technical direction for accomplishing the work of the unit or team.

ensures that work assignments of employees in the unit or team are carried out. Performs a variety of leadership functions to ensure the work of the organization is carried out.

ensures the organizations strategic plan, mission, vision, and values are communicated to the team/unit and integrated into the teams strategies, goals, objectives, work plans and work products and services.

Articulates and communicates to the team the assignment, project, problems to be solved, actionable events, milestones, and/or program issues under review, deadlines and time frames for completion.

The Lead Health Benefit Assistant may meet angry and potentially violent customers. Position requires a high level of concentration and knowledge of military data is recommended.

Work Schedule: Monday - Friday; 7:30AM-4:00pm or 8am-4:30PM (Subject to change based on the needs of the agency). Virtual: This is not a virtual position.

Position Description/PD#: Lead Health Benefits Assistant/PD04590A Relocation/Recruitment Incentives: Not Authorized. Critical Skills Incentive (CSI): Not Approved.

Permanent Change of Station (PCS): Not Authorized.