Summary This position is for a Health Benefits Assistant (HBA), located within the Eligibility & Enrollment section of Erie VA Medical Center. The HBA reports to the Supervisor of Enrollment & Eligibility, subordinate to the Chief of Business Operations. This position is to perform adjudication of a final federal VHA benefit entitlement (with or without financial liabilities) in conjunction with process procedures defined by the Health Eligibility and Enrollment Division (EED). Responsibilities Major Duties: this position is to perform adjudication of a final federal VHA benefit entitlement (with or without financial liabilities) in conjunction with process procedures defined by the Health Eligibility and Enrollment Division (EED), Health Eligibility Center(HEC). Data quality management in assuring that all information entered into the various eligibility packages is accurate, with appropriate eligibility and entitlement for medical benefits identified; and citing other eligibility factors such as: Tricare, Combat, Active Duty, CHAMPVA, Allied Vietnam and Collateral registration are completed. Receives and reviews applications, processes applications and means tests to completion within 5 business days of receipt. Performs definitive determination as to whether the Veteran is authorized for medical benefits by reviewing military service discharge papers, military identification cards, letters of awards for service-connection, service connection disability pension, and by evaluating and assessing POW, Purple Heart status. Verifying appropriate time in service eligibility criteria are met and other special eligibility. Responsible for patient specific demographic data entry and ensuring that financial information is accurate. Serve as back up to Admin Officer of the Day for death details process and Patient Funds Clerk Procedures, absence of an AOD, or when directed by Supervisor or designated representative. Responsible for preparing the cover letter for each application advising the Veteran of additional information necessary to finalize processing the application. Ensure the file and VistA contain the ineligible alert to prevent treatment in the future should the applicant apply for services. Ensures the Supervisor is consulted in those instances where eligibility cannot be established and immediate treatment must be provided to stabilize the applicant in question. Obtaining necessary documentation, which identifies the disabilities to ensure the services provided are for those cited disabilities only. Processes Purple Heart awards presented or discovered impacting Veteran during the enrollment process and/or by the enrolled Veterans and/or their representatives. Work Schedule: Monday - Friday 8:00 am - 4:30 pm. Compressed/Flexible: Not Authorized. Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Health Benefits Assistant/PD01769A Relocation/Recruitment Incentives: 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. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. 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 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, 05/21/2026. 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-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: 1) Interviews patients applying for medical benefits and entering demographics, insurance, and income information in to Databases. 2) Verifies eligibility/entitlement benefits for all applicants. 3) Actively listens to customers through demonstrating respect and concern for customer concerns. 4) Acquires Primary Team assignment utilizing internal appointment request systems. and 5) Monitors enrolled patient database information on a regular basis for updates to health insurance data and income assessments, . OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 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, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. (TRANSCRIPTS REQUIRED). OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of 6 months 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. 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 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/.
