Lead Medical Support Assistant; Health

Lead Advanced Medical Support Assistant For Health Benefits

The Lead Advanced Medical Support Assistant for Health Benefits is primarily responsible for leading staff, under the supervision of the Supervisor of Health Benefit Administration, in the intake and administrative processes for Veterans and beneficiaries applying for eligibility within the Veterans Health Administration (VHA). Duties include but are not limited to:

• Interviews and registers applicants in VES software to determine eligibility and legal entitlement of applicants for health care, including assignment into the appropriate enrollment priority group.
• Verifies eligibility using various methods, including income assessments, military discharge documents, Veteran information solutions (VIS), and other means such as communications with a VA Regional Office.
• Advises and counsels Veterans and their beneficiaries or representatives of financial obligations, co-pay requirements, and their rights to appeal
• Resolves complex eligibility, co-pay, and insurance questions that arise
• Assists AMSAs using VHA regulations, standard operating procedures, and various information systems in making eligibility determinations that may be more intricate due to special factors that may be involved in the Veteran's service record.
• Gathering, entering, and updating demographic, employment, insurance, and income verification into the enrollment system (VES), Veteran Integrated Software Technology (VistA), and other related programs.
• Monitor or be assigned to process electronic health care applications and/or determine eligibility and schedule Primary Care appointments for Veterans on initial enrollment
• Processes claims for hardship determinations, catastrophic disability, beneficiary travel deductible waivers, and appointment/inpatient stay copay waivers.
• Routinely provides administrative processing in emergency situations, such as patients being directly admitted to the Emergency Department with immediate needs. Assists the supervisor in leading change initiatives throughout the Eligibility and Enrollment Section.

Work Schedule:

Monday - Friday, 8:00am - 4:30pm

Telework:
Not Available

Virtual:
This is not a virtual position.

Functional Statement #: 34365F

Relocation/Recruitment

Incentives:

Not Authorized

Permanent Change of Station (PCS):
Not Authorized