Patient Services Assistant

Eligibility/Enrollment Clerk

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.

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 assess 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.

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.

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.

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.

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.

Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/13/2025. You must qualify for the GS-05 grade level based on your experience and/or education as described below:

GS-05 grade level: One year of specialized experience (equivalent to the GS-04 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization.

Specialized experience includes: 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, Applicants may substitute education for the experience required for the GS-05 level. 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.

OR, Applicants may also combine education and experience to qualify at the GS-05 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.

A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

You will be rated on the following Competencies for this position: Accountability Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning Reading Comprehension Reasoning Self-Management Stress Tolerance Teamwork

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.

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