Summary The Financial Management Specialist serves as a senior member of a medical claims processing team within the Financial Healthcare Service of the VA Financial Services Center Responsibilities Major Duties Analyzes provider and vendor contracts to determine negotiated fee schedules and ensures provider payment contract terms are correctly entered into the medical claims adjudication system. Creates claim adjudication runs and payables batches in portal software; designs written instructions and establishes procedures for closing payables batches. Ensures that cancelled financial payments are reviewed and necessary corrective actions are taken. Creates and researches accounting records; audits records and payments for accuracy; and audits overpayment/debts as required. Responds to customer/provider/vendor inquiries and ensures the accuracy of vendor file information. Responds to inquiries concerning payment or audit-related information Work Schedule: Monday - Friday 7 am - 3:30 pm Compressed/Flexible: Available if management approved Remote: This is a remote position; the employee will work from home. Position Description/PD#: PD04462A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required Permanent Change of Station (PCS): 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 You may be required to serve a probationary period 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 identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. As a condition of employment for accepting this position, you may be required to serve a one year probationary period or two 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 one year probationary period or two year 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, 09/25/2026. 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-09 position you must have served 52 weeks at the GS-07. 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 some former Federal employees applying for reinstatement, as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. See the Required Document section below for more information regarding the SF-50s needed to verify time-in-grade. You may qualify based on your experience and/or education s described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Experience performing Tier-2 technical support and troubleshooting functions of medical claims software systems. Demonstrated proficiency in customer service and clear communication with medical providers, vendors, and other customers. Demonstrated experience in problem-solving and collaboration while working in customer support operations. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have: Master's or equivalent graduate degree, or 2 full years of progressively higher-level graduate education leading to such a degree, or LL.B. or J.D., if related OR Combination: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond a Master's degree. 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: Resume must include job title and employer name, number of hours worked per week, start and end dates (including month and year), list of duties and responsibilities for each position held. In addition, if the experience was a federal position, you must list series and grade for each position held. Failure to include this information may result in an ineligible rating. A full year of work is considered to be 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: There are no special physical demands. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/. Career Transition Assistance Plan (CTAP) provides 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 found well qualified, applicants must meet the following qualifications: Experience performing Tier-2 technical support and troubleshooting functions of medical claims software systems. Demonstrated proficiency in customer service and clear communication with medical providers, vendors, and other customers. Demonstrated experience in problem-solving and collaboration while working in customer support operations. Information about 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/. Local Commuting Area: The local commuting area for this position is defined as a radius of 50 miles from Austin, TX . This includes all locations that fall within a 50-mile driving distance from 8000 Metropolis Dr. Austin, TX 78744. 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: Recognition of Foreign Qualifications | International Affairs Office. 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 (HRA) at The Fair Chance Act. Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This job opportunity announcement may be used to fill additional vacancies. Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members. For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document. 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 here: https://appsupport.usastaffing.gov/hc/en-us/sections/28980686389652-Reasonable-Accommodation-Information
