Summary The primary purpose of this position is to respond to basic questions and resolve issues pertaining to administrative support of medical center pharmacies and other related services to veterans, veteran family members and/or representatives, the public, and VA employees. Responsibilities Duties Major duties include, but are not limited to: Places outbound telephone calls and answers inbound telephone calls concerning billing inquiries, responds to questions and concerns, and clarifies billing determinations made by the pharmacy technician review team. Explains VA standards on secondary/adjunct conditions and the process of adjudication for additional or worsening SC conditions as well as dispute procedures. Responds to questions and concerns involving complex billing issues. Places and/or receives telephone calls and provides information about VA and related non-VA benefits available to Veterans and their dependents and beneficiaries. Calls involve a broad range of topics and include first party and third-party billing and debt collection, preregistration, Veteran record updates, Veterans' benefits, eligibility requirements, and credit card payments. Provides information concerning how to complete annual income means/copay tests and their importance in the determination of pharmacy prescription copayment exemptions. Reviews master record information contained within the Veterans Health Information Systems & Technology Architecture (VistA) system, Veterans Health Administration Enrollment System (VES), and Electronic Health Record (EHR). Explains in detail the process of filing a claim for benefits, eligibility requirements, repayment plans, and waivers, and advises what forms, evidence, and documentation must be submitted, along with other relevant information needed for each action. Prepares well-defined case notes when additional actions or referrals are indicated, available resources are insufficient to answer the caller's inquiry, and/or additional research is required. Determines the most appropriate action or identifies alternatives in resolving issue(s) through in-depth research, interpretation and analysis of master record information contained within VistA, Computerized Patient Record System (CPRS), EHR, Veteran Patient Statement (VPS), VES, Consolidated Mail Outpatient Pharmacy (CMOP), Customer Relationship Management (CRM) systems and other applicable resources and guidelines during telephone interactions. Work Schedule: Full-time, 40 hours per week, Monday through Friday, 8-hour shift between 7:00 am - 4:30 pm. Official tour of duty will be selected based on business needs. Remote: This position is not authorized for Remote work. Telework: This position is not authorized for Telework. Virtual: This position may be authorized for Virtual work. Virtual eligibility will be discussed during the interview process. Definition of Virtual work: Employee works outside of original hiring duty station at VA-owned or leased space. Return to Office (RTO): RTO exemptions will be considered and a determination will be made as part of the selection and onboarding process. Position Description/PD#: Contact Representative/PD06845A 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 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 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, 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, 02/17/2026. GS-5 Time-In-Grade Requirement: There is no Time-In-Grade Requirement for the GS-05 level. GS-6 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. 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: Ability to research and apply knowledge on regulations, policies, and/or procedures Prepare oral/written responses to internal and external customers. Perform data entry in various computer systems. Provide customer service to customers/patients. The ability to provide instructions to customers/patients. or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. OR GS-05: Combination of Education and Experience (TRANSCRIPTS REQUIED): A combination of successfully completed education and experience to meet the total experience requirements. (i.e. 6 months of specialized experience and 3 years of education above the high school level). NOTE: Only education beyond the second year can be used in combination with specialized experience to qualify for this grade. 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: Ability to manage time and work effectively. Provide guidance to patients/customers on laws, regulations, policies, and procedures. Process requests to update customer/patient information in a computer database. Perform telephone calls in a high-volume response environment (i.e. customer call center). Resolve conflicting or inconsistent information in customer/patient files. OR GS-05: Substitution of Education for Experience (TRANSCRIPTS REQUIRED): Four (4) years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university. 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. 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 There is no educational substitution at the GS-6 grade level. 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 for 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 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/.
