Summary The position is located in the Health Administrative Services, Patient Services Section, at VHA Central Western Massachusetts Health Care System, in Springfield MA. The incumbent examines and processes claims/applications for Veterans services, benefits and programs. Responsibilities The work includes varied duties requiring many different and unrelated entitlement processes and different methods that are applied to a broad range of VA and Non-VA Care activities. The incumbent is able to independently manage position responsibilities with little supervision and set priorities and deadlines adjusting the flow and sequencing of the work to meet team and customer needs. Makes determinations on entitlements based on current regulations, laws and policies; evaluates qualifying documentation, ensures compliance with regulation and authority when making entitlement process decisions for new and renewing Veterans. Other duties include: Examines a variety of routine and complex claims/applications for entitlement and/or payment, to include adjudication of authorized and unauthorized services, programs, travel for Veteran and Family Member programs for within a worldwide VA claims benefits program. Examines vouchers, invoices, claims, and other requests for entitlements for programs and services provided to or by the Government or for reimbursement of expenditures for travel and transportation, for accuracy, adequacy of documentation, or citations, compliance with regulations, and justification for Veteran and Family Member programs in a worldwide VA claims benefits program. Examines a full range of vouchers having a wide variety of complicating factors to include contradictory entitlement criteria found in certain special authorities, congressional actions, special considerations, VBA and HEC adjudications, fiscal exemptions, and non-routine payment authorizations. Researches and gathers information, identifying and analyzing issues, and preparing documents. Addresses problems and issues of varying complexity; situations vary significantly with each assignment. Corrects registration inconsistencies, enters external data and responds to entitlement queries by utilizing various established tracking methods (e-mail responses and spread sheet). Ensures claims, vouchers and other financial documentation is accurately and correctly completed for inpatients. Determines adequacy of information in support of a claim. Reviews all claims/applications to ensure necessary processing information is present or suspends/rejects claims/applications to appropriate queue. Authorized payments and determines the adequacy of invoices and the amount to be paid. Enters payment information into a computerized claims payment processing system which is applicable to the claim @type, and program @type unless internal or external correspondence is required. Reviews claims/applications for payment or reimbursement for entitled services. Determines whether a claim meets certain basic criteria. Certifies vouchers for payment and enters/submits those certified vouchers into a centralized automated system. Prepares correspondence to all parties involved, including letters transmitting adverse decisions or requests for additional information. Promotion Potential: The selectee may be promoted to the full performance level (GS-06) 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. Work Schedule: Monday - Friday 7:30 am - 4:00 pm, 40 hours a week, EST. Telework/Remote: Not Authorized Virtual: This is not a virtual position. Position Description/PD#: Voucher Examiner/PD029130,02912 Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Note: This position is in the Competitive Service. This position is covered by locality-based comparability pay. This is not in Bargaining Union Position. Interchange Agreements with Other Merit System: Employees who occupy medical or medical-related positions and were appointed under 38 U.S.C. 4701(1) or (3) [formerly 38 U.S.C. 4104 (1) and (3)] must be serving in a full-time position without time limit and have served continuously for at least one year in this other merit system to be eligible to convert to the Title 5 System. Some exceptions to this rule may apply if you have previously acquired tenure under a Title 5 appointment. Current employees must submit copies of their most recent SF-50, (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure and @type of service (Competitive or Excepted). In some cases, more than one SF-50 may be required to show a higher grade previously held. Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period or trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 12/01/2025. 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. There is no time-in-grade requirement for the GS-05 level. 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: GS-05: 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: working under close supervision in an office environment. examining documents to accuracy and completion; knowledge of programs and services that assist Veterans, preparing correspondence including adverse decisions, providing technical advice both verbally and in writing on a broad range of subjects, use of standard computer software including email, word processing and spreadsheets. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school. Degree must be relevant to the position to be filled. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement. One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience. The education and experience must be directly related to the work of the position to be filled. GS-06: 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: working independently in an office environment. examining documents to accuracy and completion; knowledge of programs and services that assist Veterans, preparing correspondence including adverse decisions, providing technical advice both verbally and in writing on a broad range of subjects, use of standard computer software including email, word processing and spreadsheets. Education: There is no educational substitution for this series at this grade level. You will be rated on the following Competencies for this position: Attention to Detail Computer Skills Customer Service (Clerical/Technical) 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, although some walking, stooping, bending, reaching, and carrying loads weighing up to 10 pounds is required. Data entry using a keyboard is required. 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/. Education A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act. Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.
