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Health Benefits Contact Representative

Serves as the subject-matter expert and is responsible for applying an extensive body of rules and regulations relative to Veterans Eligibility for VA healthcare benefits, interpretation of relevant laws, VHA guidelines and regulations, and other federal agency policies is required to ensure that timely and appropriate measures are taken throughout data collection and data entry processes.

Processing requests to update veterans personal, eligibility and enrollment information, entering demographic, insurance, and income information.

Serves as a base for determining entitlement to medical care as well as bill preparation and collection on all billable episodes of inpatient and outpatient care.

Accurate and complete data collection is essential to proper processing of third-party collection requirements as mandated by law.

Serve as expert benefit representative to HAS Leadership and support the management information components of all health eligibility related programs.

Provides administrative support and collaborates with inpatient staffing personnel such as Physicians, Physician's Assistants, Nurses, Advanced Registered Nurse Practitioners, Dietitians, Social Workers, and other administrative and professional staff throughout AAVAMC area transitioning patients identified as ineligible for VA patient care.

Accurately generates patient data cards for veterans through the Identity Management Toolkit for proofing identity and the Veterans Health Identification Card (VHIC) System.

Monitors enrolled patient data base information on a regular basis (at a minimum, annually) to perform updates to health insurance data, income assessments for the Means Test and Pharmacy Co-pay Exemption programs as mandated by law.

Prepares written correspondence for a broad spectrum of complex inquiries from intel and external customers by independently recognizing issues, topics, or problems.

Prepares, composes, and reviews correspondence prepared for the purpose of obtaining or supplying information.

Resolves conflicting or inconsistent information by dealing with various VA offices, sorting out errors and researching past transactions, cases or events.

Managing the NEAR list and electronic wait list to verify and validate accuracy and resolve issues; providing input during team meetings and to assist in resolving problems having to do with enrollment issues, or panel assignments.

Generates and monitors enrolled patient data base information for accurate health insurance data

Provide exceptional customer service by exceeding the customer's expectations

Actively listen to customers with respect and concern; the incumbent will pay attention to the details of the customer's needs and help the customer arrive at a satisfactory solution to the problem

Communicates and interacts with patients in a manner which is appropriate to cognitive, emotional, and chronological maturation needs of the adult and/or geriatric patient.

Perform all other related duties as assigned.

The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Monday-Friday 8:00am to 4:30pm

Not Authorized

This is not a virtual position.

Contact Representative

PD92690A

Not Authorized

Not Approved

Not Authorized

Not required