Contact Representative

Job Title

Job Title

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This job is open to current permanent Department of Veterans Affairs employees. Area of consideration - Eligible applications will be reviewed and referred in the following order:

1. Current VA employees designated as surplus or displaced by the VA - Career Transition Assistance Plan (CTAP) eligible
2. Current VA employees of the Office of Integrated Veteran Care (current SF-50 must show IVC in box 22 or 135 in box 40)
3. Current VA employees of the Veterans Health Administration (VHA) (current SF-50 must show VHA in box 22)
4. Current permanent employees of the Department of Veterans Affairs

Duties include, but are not limited to:

• Responsible for the processing and making legal determinations on: CHAMPVA, a comprehensive health care program administered by the Department of Veteran Affairs (VA) for the spouse or widow(er)and children of an eligible Veteran.
• Technical expertise in interpreting and applying administrative and clinical eligibility and enrollment laws, regulations and procedures related to health care eligibility. The incumbent makes formal determinations and issues formal decisions on applicant's eligibility for CHAMPVA.
• Searches external databases and requests eligibility information from Veterans Benefits Administration (VBA) (VIS, SHARE and VBMS), and from Veterans and family members to determine program eligibility.
• Examines applications for possible errors and acts according to current operational policies, as well as exercising judgment in resolution where policies may be vague, or interpretation may be required. The incumbent must use their own judgment to make decisions based on their knowledge for both routine and unusual situations.
• Examines the database for factual, legal accuracy, identifies possible errors and acts accordingly to incorporate current operational policies, as well as exercising judgment in correcting erroneous data in the system.
• Makes appropriate entries in application processing databases to record eligibility and clinical status. Incumbent creates new beneficiary files in the Veteran Eligibility System (VES), or updates established records and determines whether the entry reflects proper program determinations have been made and maintained.
• Receives and initiates correspondence and emails with beneficiaries, Veterans Services Offices, VA Regional Offices, CMS/Medicare, the VA Health Eligibility Center, the Financial Services Center, physicians, nurses, and other interested parties, regarding development of determinations on VA benefits for eligibility.
• Assists Veterans, their beneficiaries, and other interested parties, with the application process and obtaining a program authorization. Explains administrative procedures and policies in the processing of applications for benefits, and any time delays in the administration of benefit eligibility. Verification of data entry of initial application input and determines eligibility.
• Responds to inter-agency communication through the Customer Relationship Management (CRM) tool. Has the duty to review tasks, input incoming eligibility information into VES, provide timely responses to external inquiries, and complete CRM tasks.

Work Schedule: Monday- Friday 6:30 a.m.- 4:30 p.m. EST

Telework: Not eligible

Virtual: This is not a virtual position

Position Description/PD#: Contact Representative/ PD74547A

Relocation/Recruitment Incentives: Not Authorized

Critical Skills Incentive (CSI): Not Authorized

Permanent Change of Station (PCS): Not Authorized

PCS Appraised Value Offer (AVO): Not Authorized