Medical Support Assistant (Advanced)

Full Job Description

This position serves as an Enrollment and Eligibility Specialist for the Patient Administration Section (PAS).

The MSA determines eligibility for VA healthcare benefits which requires an extensive knowledge of VA laws, directives, policies, and procedures.

MSAs provide record keeping and administrative support for the following areas: Eligibility & Enrollment, Emergency Department, Environmental Health Registries, Centralized Check-in, Appointment Scheduling and Beneficiary Travel Section.

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Experience and Education: Experience.

6 months experience of clerical, office, [customer service], or other [administrative] work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position OR, Education.

One year above high school; OR, Experience/Education Combination.

Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable Certification: None required.

Foreign Education: To be creditable, education completed outside the U.S.

must have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and such education must have been deemed at least equivalent to that gained in conventional U.S.

programs.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

Grandfathering Provision.

All MSAs employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series, and grade held, [which] are [a] part of the basic requirements of the occupation.

For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply: (1) Such employees may be reassigned, promoted, or [changed to a lower grade] within the occupation.

(2) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis, until they fully meet the basic requirements of the standard.

(3) If an employee who was converted to [Title] 38 hybrid status under this provision leaves the occupation, the employee loses protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation.

Grade Determinations: Advanced Medical Support Assistant GS-6 Grade Level: Experience: One year of experience equivalent to the [GS-5] grade level.

Experience is defined as experience that includes, but is not limited to: scheduling, canceling, re-scheduling patient's appointments and/or consults; entering no-show information; monitoring the electronic wait list; preparing for clinic visits; monitoring both inpatient and outpatient appointments for areas of responsibility; ensuring encounter forms are completed in order to obtain appropriate workload credit; verifying and updating demographics and insurance information; processing all emergency and non-emergency transfers to other VA facilities or private hospitals; performing basic eligibility, co-pays and pre-authorization requirements for specific coverage (i.e., TRICARE, sharing agreements, etc.).

Candidates must also be able to demonstrate ALL of the following Knowledge, skills, and abilities for the GS-0679-6 level to qualify for this position: Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g.

medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.

Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations.

Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers.

This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns.

Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care.

Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc.

Advanced knowledge of medical terminology and abbreviations Preferred Experience: Scheduling, canceling, re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources; participating in huddles with other MSAs and/or clinic staff to determine the daily needs of the clinic; monitoring both inpatient and outpatient appointments; verifying and updating demographics and insurance information when patients check in for appointments.

Providing clerical support in a hospital ward, knowledge of patient admissions (determining eligibility) and outpatient processing procedures.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is a GS-06.

The actual grade at which an applicant may be selected for this vacancy is a GS-06. Physical Requirements: VA Directive and Handbook 5019.

Work is partially sedentary, with frequent walking, standing, bending. carrying of light items such as papers and books, or small parts. Some slight physical effort may be required.

Incumbent may be susceptible to eyestrain from working long hours on the computer. Major Duties:

VA Careers - Medical Support Assistant: https://www.youtube-nocookie.com/embed/EE9c4XkaELo Total Rewards of a Allied Health Professional Duties: MSAs will serve as experts and support the management information components of all health eligibility programs.

The MSA will be assigned work and/or receive training with the objective of acquiring the qualifications needed to successfully facilitate all administrative aspects of the enrollment process, health eligibility determinations and related aspects of health benefits administration as well as successfully performing a wide range of administrative functions in support of both administrative and clinical service lines.

This includes not only entering data and information when necessary, but also reviewing reports, records and statistical computations for accuracy and propriety.

Local input is compared with the Health Eligibility Center (HEC) in Atlanta, GA and also will affect the data entry for encounter entries that go to Austin for workload credit.

The MSA must review the Incomplete Encounter Management Module (IEMM) report in order to clean up any discrepancies in administrative data that would prevent the transmission of encounters.

Reviews, verified, and analyzes data submitted for consistency with financial and program objectives in adherence to VA directives.

MSAs must enter all information into the data base for determination of the eligibility status for Healthcare: Patient Demographic Data Patient Data ]Emergency Contact Data Employment Data Insurance Data Military Service Data Eligibility Status Data Family Demographic Data & Income Screen Data Ineligible/Missing Data Eligibility Verification Data MSAs will also assure that all new veterans to the system are registered within 5 business days of receipt of their application.

All new eligible applicants will be offered an opportunity to schedule a new patient appointment with the appropriate clinic in adherence to local and national guidelines and policies.

MSAs are expected to provide exceptional customer service by exceeding the customer's expectations.

The MSA will actively listen to customers with respect and empathy; will pay attention to the details of the customer's needs and help the customer arrive at a satisfactory solution to the problem.

The MSA will be flexible, adaptive, and enthusiastic to exceed the customer's needs. Facilitate the process of issuing enrolled Veterans a Veteran Health Identification Card.

Determine veterans' eligibility for beneficiary travel reimbursement from their residence on record to the closest VA facility that offers the service by privately owned vehicles or common carrier & processes eligible travel claims.

Denies travel reimbursement to ineligible applicants, providing a brief explanation for the denial and provides rights to appeal.

MSAs will be required to perform their primary role and related aspects of health benefits administration in direct support of Emergency Department operations such as enrollment & eligibility, registration, pre-registrations, decedent affairs, admissions & inpatient movements and all aspects of scheduling (including the checking in of scheduled and unscheduled appointments).

MSAs will coordinate facility transfers both internal and external.

MSAs must be able to interpret and communicate requirements of VHA scheduling directives and complete accurate scheduling responsibilities and assist in training other MSAs as follows: Schedule appointments in a timely manner.

All appointments will be made with the patients input.

Notifies his/her supervisor when clinic access is less than desirable or if an individual patient cannot be scheduled within mandated clinic timeframes.

Other duties as assigned Work Schedule: Monday - Friday; 8:00am - 4:30pm Recruitment Incentive (Sign-on Bonus): Not authorized Permanent Change of Station (Relocation Assistance): Not authorized Pay: Competitive salary and regular salary increases Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.

Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66.

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: Not available Virtual: This is not a virtual position.

Functional Statement #: 23149-F Permanent Change of Station (PCS): Not Authorized