Summary Employees will serve as a Contact Representative assigned to the VA Office of Integrated Veteran Care (IVC), Customer Service, in Lakewood, CO. Customer Service is a high-volume call center environment where the primary purpose of the position will be to advise and assist patients/clients, beneficiaries, and other stakeholders regarding available services, benefits, and claim-related matters. Responsibilities THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION This announcement has an applicant count cut-off. Once 300 applications are received, the announcement will be removed from USAJOBS at 11:59pm EST on the day that the applicant count is reached. These positions involve a multi-grade career ladder. The major duties listed below represent the full performance level of GS-8. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-8. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher level work, and availability of funds. The major duties include but are not limited to: Conducts telephone interactions and creates responses to inquiries regarding any program administered by the IVC; Records new and/or updated information in computerized database(s) necessary for maintaining, routing and tracking correspondence; Develops, examines, adjusts, reconsiders, recommends settlement of various @types of claims, receives and processes requests for authorization of healthcare services, supplies and benefits; Routinely researches and locates information that is missing or lacking in detail to ensure the submission is complete and adequate for processing; Furnishes information concerning rights and benefits with regard to assigned health benefit programs; Provides customers with advantages and disadvantages to various benefit options and discusses various alternatives; Assists in determining the status of claims for services; Explains and advises the basis for payment decisions and reasons for disallowance; Explains payment methodologies used in adjudicating medical claims to resolve questions about allowable amounts and cost shares; Works directly with patients/clients, beneficiaries, providers and collection agencies in an effort to mitigate or resolve situations in which the patient/client or beneficiary has been placed in an adverse credit situation due to non-payment and/or untimeliness of payment of medical claims; Advises, counsels and reviews applications for benefits for assigned health benefit programs administered by the IVC; Conducts and/or assists in the testing of new programs, enhancements to existing processes and new initiatives impacting customer service; and Performs other related duties as assigned. Work Schedule: 8-hour tour, Monday-Friday between 5:45 a.m. - 7:15 p.m. (Mountain Standard Time) based on business needs. Recruitment/Retention Incentive Approved: To support recruitment and retention in these fast-paced Contact Representative positions, newly appointed VA employees may be eligible for a $4,000 incentive in exchange for a 2-year service agreement. Telework: This position may be authorized for ad-hoc telework. Applicant will be required for on-site work. Telework eligibility will be discussed during the interview process. Promotion potential to GS-8, Step 10: $80,997.00 per year. Pay may be set at a rate/step above the minimum rate (AMR) for applicants with superior qualifications. Paid Time Off: 37-50 days of annual paid time off per year, including 13-26 days of annual leave, 13 days of sick leave, and 11 paid Federal holidays. Selected applicants may qualify for credit toward annual leave accrual based on prior work experience or military service experience. Parental Leave: Up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child. Child Care Subsidy: After 60 days of employment, full-time employees with a total family income below $144,000 may be eligible for a child care subsidy of up to 25% of eligible child care costs for qualifying children, up to a monthly maximum of $416.66. Retirement: Traditional Federal pension (5-year vesting) and Thrift Savings Plan (TSP) with up to 5% matching contributions by VA. Insurance: Federal health, vision, dental, term life, and long-term care insurance programs. Many Federal insurance benefits may be carried into retirement. Critical Skills Incentive (CSI): Not Approved 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 PHYSICAL REQUIREMENTS: The work is primarily sedentary although some walking, stooping, bending, reaching and carrying loads weighing up to 20 pounds is required. Use of computer and telephone is extensive. Work is performed in a fast paced and sometimes stressful professional office environment. 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) - See "Required Documents" below for details. 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, 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, applicant(s) must meet at least one of the qualification requirements described below. SPECIALIZED EXPERIENCE: You must have at least one (1) full year of specialized experience equivalent to the GS-4 level in the Federal service that equipped you with the particular knowledge, skills, and abilities to perform successfully the duties of the Contact Representative position, and that is typically in or related to the work of the position. Specialized experience includes: Conducting telephone or other customer service interactions; Researching and resolving customer inquiries or complaints; Inputting and retrieving information using multiple computer systems; Analyzing information to provide accurate responses; Preparing correspondence or documentation; and communicating effectively with customers in a high-volume or fast-paced environment. OR EDUCATION (TRANSCRIPT REQUIRED): Successfully completed four (4) years of education above high school in any field for which high school graduation or the equivalent is the normal prerequisite. OR COMBINATION (TRANSCRIPT REQUIRED): Equivalent combinations of successfully completed post-high school education (beyond the second year) and specialized experience, as described above, which meet the total qualification requirements for this grade level. Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. 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. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. 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 IMPORTANT: 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 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. 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. 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. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 80 or more before any Veterans preference points) for this vacancy. 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/.
