Summary The Eligibility-Enrollment Clerk position is in the Enrollment/Means Test Unit Section under the supervision of the Member Services Supervisor. The incumbent is responsible for verifying and certifying the legal eligibility of applicants seeking medical treatment and/or benefits. Responsibilities Major Duties for this position include: Make the initial determination whether the veteran is legally eligible for dental benefits by reviewing military service records and/or letters of awards for service-connection. Investigate authorizations, orders, and/or utilizes the Computerized Patient Record System (CPRS) to review medical records, forwards for supervisory approval and submits all documents for payment utilizing appropriate control point for reference. Act as liaison between vendors and Fiscal Service for invoices pending payment. Evaluate and asses prisoner of war status, combat veteran status, financial (means test) standards, and other special eligibility criteria. Initiate computer inquiries through HINQ or VIS computer databases to determine eligibility for each application received to continue processing. Access Hospital Inquiry System (HINQ), Veterans Information Solution (VIS),Veteran Benefit Management System (VBMS), Health Eligibility Center (HEC), and Regional Office (RO) as necessary to determine Veteran eligibility for care, priority group and VA benefits that they qualify for. Maintain the HINQ Suspense File and ensure all updates are completed in VistA. Work Schedule: Monday-Friday 8:00am - 4:30pm (work hours may be further discussed during interview process). Telework: Not Available. Virtual: This is not a virtual position. Position Description Title/PD#: Patient Services Assistant/40262A. Relocation/Recruitment Incentives: Not authorized. The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the @context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being. 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 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. 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 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, 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, 12/12/2025. You may qualify based on your experience and/or education as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-4 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include: Performing administrative assistance in support of a medical facility; Utilizing software programs to enter, retrieve and edit data; Preparing written correspondence; Maintaining files; Analyzing documents to determine medical care eligibility; Copying and scanning legal documents to update electronic records. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed four (4) years of education above the high school level in any field which high school graduation or the equivalent is the normal prerequisite. Transcripts must be submitted at time of application. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an equivalent combination of successfully completed post-high school education (beyond the second year) and specialized experience as described above, which meet the total experience requirements for this grade level. Transcripts must be submitted at time of application. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-05. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position A transcript must be submitted with your application if you are basing all or part of your qualifications on education. 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 mainly sedentary but requires some light walking, standing, bending, and lifting. The position requires constant viewing of a computer screen and hours of keyboarding daily. Infrequent walking to various locations of the Hospital with records of patients is necessary. Work Environment: The incumbent could possibly be exposed to communicable diseases, possible physical abuse if exposed to an emotionally disturbed patient or distraught visitors because of the @type of patients. Work is performed in an office @type setting. 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 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. 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. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. 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. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA/federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.
