Experience:
No experience
Employment Type:
Intern/Co-op
Posted:
8/1/2016
Job Category:
Social Service
Industry:
Health Care & Medicine
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Claims Assistant
U.S. Department of Veterans Affairs | Milwaukee, Wisconsin
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Job Description

Duties:
As a Claims Assistantin the Veterans Service Center (VSC) for the Veteran Benefits Administration you will:

  • Conduct initial review of incoming mail to determine action needed.
  • Establish or update actions using Department computer applications.
  • Check all forms and evidence submitted for completeness and accuracy and routes them to the proper operating element.
  • Request and route claims folder/e-folder/claim to the appropriate team for further action when evidence is received.
  • Develop straightforward evidence in conjunction with claims and assists the VSR with the gathering of evidence for more complex cases.
  • Utilize software systems to perform jobs, ie., BDN, COVERS, CAPRI, VACOL, PCGL, PIES, SHARE, VBMS and WORD.
  • Analyze claim and determine if disposition of claim and control action has been appropriately identified.
  • Perform administrative duties in support of the team.
  • Responsible for the care and maintenance of claims folders/e-folders.
  • Process dependency questionnaires and admission notices.
  • Greets customers and explains basic VA benefit programs and entitlement criteria.
  • Work Schedule:Monday-Friday 8am-4:30pm. Flexiblework schedule available at the discretion of the supervisor.

    Position Description Title/PD#:Claims AssistantGS-0998-05/05full performance level 6PD 330-12112A

    Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

    Time-in-grade: Applicants who are/were current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements.

    GS-05: There are no time-in-grade requirements for the GS-05 level.

    To support your claim that you have the required time-in-grade, you must submit your most recent promotion, within-grade increase, or appointment SF-50. If you previously held a higher grade, you must also submit any SF-50 showing that grade.

    Qualifications:
    To qualify for this position, applicants must meet all requirements within 30 days of the closing date of the announcement.

    Recent Grad Program Eligibility Requirements:
    The Pathways Recent Graduates Program is open to recent graduates who are legally permitted to work in the U.S. To be eligible, you must have completed, within the previous two years, a qualifying associates, bachelors, masters, professional, doctorate, vocational or technical degree, or certificate from a qualifying educational institution. Veterans unable to apply within two years of receiving their degree, due to military service obligation, have as many as six years after degree completion to apply. For more information on eligibility requirements for the Pathways Internship Program, review the VA Pathways Program Requirements.
    Specialized Experience:

    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.


    Applicants must have one year of specialized experience equivalent to at least the next lower grade in the normal line of progression for the occupation in the organization.Specialized experience is defined as work that involves (1) Experience in the development of claims for various types of benefit and procurement of relevant evidence, (2)The ability to control electronically and maintain pertinent files and documents in the claims process,(3) Work in which the applicant showed evidence of working knowledge of the claims processing programs.

    GS-05: One (1) year of specialized experience equivalent to the GS-04 grade level or equivalent.

    Applicants may substitute education for the experience required:

    GS-05: Successful completion of 4 year above high school education in an accredited college or university which demonstrate the knowledge, skills, and abilities necessary to do the work.

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

    Physical Requirements: The work is mostly sedentary. However, there may be some walking, standing, and carrying of light items such as papers, books, claims folders, and files from one desk to another or for returning to storage. Carts are utilized to carry large number of claims folders. This will require the incumbent to push or pull the cart from one or to another.

    All applicants are required to submit the following supporting document type(s):

    Applicants may also submit the following supporting document type(s),which may not be required for all applicants:


    *Cover Letter
    *DD-214
    *Other
    *Other Veterans Document
    *Resume
    *SF-50
    *Transcript

    Current Federal Employees:

    • If you are applying using your status as a current federal employee or as a VEOA candidate (who is a current federal employee) you must submit an SF-50. To support your claim that you have the required time-in-grade, you must submit your most recent promotion, within-grade increase, or appointment SF-50. If you previously held a higher grade, you must also submit any SF-50 showing that grade.

    Résumé

    • Your résumé may be submitted in any format, however we strongly recommend using USA Jobs résumé builder as it contains all of the information required on federal résumés.
    • For qualifications determinations your résumé must contain hours worked per week, the dates of employment, and the level of your experience. If your résumé does not contain this information you will not receive consideration for this position.
    • If you submit more than one copy of your résumé, only the most recent version will be reviewed. The latest timestamp will be used to determine which version of your résumé is "most recent." It is your responsibility to check the status and timestamp of all documents you submit as part of your application.
    • If your résumé includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations and you may not be considered for this vacancy.

    Applicants claiming veterans preference must also submit:

    • A legible copy of your DD Form 214, "Certificate of Release or Discharge from Active Duty," showing all dates of service, as well as character of service (Honorable, General, etc.). The member 4 copy of your DD Form 214 is preferable. Copies of DD-214"s can be requested here.
    • Current active duty members must submit a signed statement of service from their commander dated within the last 120 days that contains their expected discharge date, their release from active duty under honorable conditions, any medals awarded, and the timeframe of their service so eligibility can be determined.
    • Veterans claiming 10 point preference must also submit an SF-15 and all documents indicated on the form as proof of type of preference. This includes a VA letter supporting your disability claim with the overall percentage listed.
    • If you are unsure as to whether you qualify for veterans" preference, please consult the U.S. Department of Labor"s Veterans" Preference Advisor here.

    Transcripts

    • If you are basing all or some of your qualifications on education or if a degree is required for the position, a transcript must be included as part of your application package.
    • Unofficial transcript(s) may be submitted, however it must contain the course names, levels, credits earned, and grades received.
    • Your transcript must contain the degree conferred date if you are substituting a degree for experience.
    • If you are claiming superior academic achievement (SAA) ensure you submit completed transcript(s) to demonstrate it. The requirements for superior academic achievement can be viewed here.
    • A photocopy of your degree is not acceptable in place of a transcript.
    • An official transcript will be required at a later date if you are selected for the position.

    Applicants claiming CTAP/ICTAP Eligibility must also submit:

    • Certification of expected separation, reduction-in-force separation notice, or notice of proposed removal; and your most recent performance evaluation; and an SF-50 demonstrating your separationor the position you will be separated from. Or
    • Worker"s compensation separation: agency certification of inability to place employee and notification of separation or a separation SF-50. Or
    • Disability annuity termination: Notification from OPM of disability annuity termination and separation SF-50 of the last position held. Or
    • Military reserve or National Guard technician special disability retirement annuity under 5 U.S.C. 8337(h) or 8456: Certification of special disability retirement annuity from a military department or National Guard bureau and separation SF-50 of the last position held.

    Failure to submit any of the above mentioned required documents may result in loss of consideration due to an incomplete application package. It is your responsibility to ensure all required documents have been submitted. You will not be contacted for additional information.

    In addition to the information listed above, please use this checklistto ensure you have included other documents required for your application.


    Keywords

    Qualifications:
    To qualify for this position, applicants must meet all requirements within 30 days of the closing date of the announcement.

    Recent Grad Program Eligibility Requirements:
    The Pathways Recent Graduates Program is open to recent graduates who are legally permitted to work in the U.S. To be eligible, you must have completed, within the previous two years, a qualifying associates, bachelors, masters, professional, doctorate, vocational or technical degree, or certificate from a qualifying educational institution. Veterans unable to apply within two years of receiving their degree, due to military service obligation, have as many as six years after degree completion to apply. For more information on eligibility requirements for the Pathways Internship Program, review the VA Pathways Program Requirements.
    Specialized Experience:

    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.


    Applicants must have one year of specialized experience equivalent to at least the next lower grade in the normal line of progression for the occupation in the organization. Specialized experience is defined as work that involves (1) Experience in the development of claims for various types of benefit and procurement of relevant evidence, (2)The ability to control electronically and maintain pertinent files and documents in the claims process,(3) Work in which the applicant showed evidence of working knowledge of the claims processing programs.

     

    GS-05: One (1) year of specialized experience equivalent to the GS-04 grade level or equivalent.

    Applicants may substitute education for the experience required:

    GS-05: Successful completion of 4 year above high school education in an accredited college or university which demonstrate the knowledge, skills, and abilities necessary to do the work.

     

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

    About U.S. Department of Veterans Affairs

    To be eligibile candidates must: 

    • have graduated with a baccalaureate degree from a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). 

    • have successfully passed the NCLEX-RN exam and hold an active, unrestricted license by the start of the program, but have no RN experience. 

    • be able to work full time on day shift with preceptors and mentors.

    • sign a statement of commitment. 

    • have a minimum cumulative grade point average of 3.0.

    • Send cover letter & resume to Cynthia.Golden2@va.gov.

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