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Title : Claims Assistant - Department of Veterans Affairs - Philadelphia, PA
link : Claims Assistant - Department of Veterans Affairs - Philadelphia, PA

Claims Assistant - Department of Veterans Affairs - Philadelphia, PA

Summary

Vacancy Identification Number (VIN): 1942897

OUR MISSION: To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans?

The Veterans Benefits Administration (VBA) provides a variety of benefits and services to service members, veterans, and their families. VBA has been undergoing a major transformation that is people-centric, results-oriented, and a forward-looking integration of solutions that will ensure total lifelong engagement with service members, veterans, and their families. For more information on the Department of Veterans Affairs, go to http://ift.tt/RuzGum

Duties

The Claims Assistant works as a member of a Pension Management Center team in the Philadelphia Regional Office, Philadelphia, PA. The Incumbent is responsible for the care and maintenance of the claims folder and insures that all pertinent records and document are preserved and are neatly and orderly filed in chronological order:
 Major Duties:
- Providing information related to basic eligibility requirements for veterans' benefits.
- Explaining current pending claims status.
- Determining eligibility and preparing entitlement letters for Civil Service Preference, commissary privileges, fishing licenses, etc.
- Preparing verification letters for type and amount of benefit.
- Preparing changes of address and processing direct deposit requests.
- Handling limited release of information requests by providing copies of documents for the claims file.
- Maintaining the integrity of the claims folder during folder review by claimants.
- Determining when a visitor requires a structured interview with a Veterans Service Representative or a higher-level Claims Assistant and retrieving the claims file when needed.
- Processing informal claims, providing the claimant with the necessary application and stipulating the appropriate time limit.
- Processing incoming Powers of Attorney; recognizes when special procedures are required due to an existing private power of attorney or recognition of a private attorney for limited issues.
- Inputting requests for VA examinations, identifying the type of exam(s), claimants' most current address, and entering additional questions that must be addressed by the examining physician.
- Performing initial procedures related to processing notices of death.
- Verifying that all forms and other evidence submitted is complete and accurate and routed to the proper department and/or team member.
- Utilizing various electronic data processing systems to validate status of claims, update systems, generate various types of correspondence, etc.
- Maintaining the integrity of the claims folder during review by claimants.
- Processing and placing incoming mail under proper system control for routing to the appropriate claims adjudication team.
Work Schedule:  Regular office hours, Monday-Friday.  Training hours will be on a set schedule, however, after training has been completed flexible shifts may be offered.
Promotion Potential:  A 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.
Physical Requirements:   The work is mostly sedentary.  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 numbers of claims folders, requiring the incumbent to push or pull carts from one area to another.  The Department of Veterans Affairs provides reasonable accommodations for persons with disabilities. 

Travel Required

• Not Required

Relocation Authorized

• No

Job Requirements

Key Requirements

• You must be a US citizen to apply for this job
• Subject to a background/suitability investigation.
• Selective Service Registration is required for males born after 12/31/1959

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of the announcement.
GS-05: One year of specialized experience equivalent to the GS-04 grade level in the federal service.
Specialized experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) 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. Examples of specialized experience include: experience in the preparation of claims for benefits; procurement of relevant evidence; the ability to control electronically and maintain pertinent files and documents in the claims process; work in which the applicant showed evidence of a working knowledge of the claims processing; and prepared the individual to successfully deal with clients from many backgrounds. Such experience may have been gained by working in an agency or insurance company that had intricate and precise procedures for processing claims.
UNPAID 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; religious; 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.
VA CAREER TRANSITION AND ASSISTANCE PROGRAM (CTAP) AND INTERAGENCY (ICTAP)
These applicants may apply if the position is within the commuting area at their current grade or a lower grade providing that it does not involve a higher promotion than current grade. Applicants must be determined to be 'well-qualified' to be referred for consideration. This means that you must provide copies of RIF notice, latest performance appraisal, Certificate of Expected Separation or other documentation issued by the agency which identifies you as being surplus are required. Additionally, a copy of your latest SF-50, Notification of Personnel Action and performance appraisal is required.
For more information, go to: http://ift.tt/1k3ubPY
OR
Applicants may substitute education for the experience required.
GS-05: successful completion of four (4) years (120 semester hours) of education above the high school level from an accredited business, secretarial or technical school, junior college, college or university.
It is the applicant's responsibility to provide documentation or proof that he or she has met the applicable educational requirements for substitution. Applications submitted without the required supporting documents will not be accepted. An unofficial transcript; statement from the institution's registrar, dean, or other appropriate official; or equivalent documentation is acceptable at the time of application. Education submitted must be appropriately accredited by an accredited body recognized by the Secretary of the U.S. Department of Education. For additional information, refer to the U.S. Department of Education web site at http://www.ed.gov/.
OR
Applicants may also combine education and experience to qualify: To calculate, first identify the percentage of required education you have earned; (only education in excess of the first 60 semester hours (i.e., beyond the second year) is creditable toward meeting the specialized experience requirement). One full academic year of study (30 semester hours) beyond the second year is equivalent to 6 months of specialized experience. Identify the percentage of required experience you possess.  Add the two percentages.  The total percentage must equal at least 100 percent to qualify.
You will be rated on the following Knowledge, Skills, Abilities and Other characteristics (KSAOs) as part of the assessment questionnaire for this position. This training and/or experience MUST be reflected by descriptions of your experience in your resume.

• Ability to comprehend interpret, and apply written procedures, guidelines, and regulations that apply to claims activities.
• Ability to independently organize assigned tasks, set priorities, and meet deadlines.  
• Ability to accurately perform work requiring attention to detail.
• Ability to demonstrate priorities and organize work to stay within prescribed time limits.
• Ability to communicate orally and with people from a variety of backgrounds.

If you are referred for consideration, you may be asked to submit additional job related information.
For more information on these qualification standards, please visit OPM's web site at http://ift.tt/1yctoqO.

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. 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.

Physical Requirements: The work is sedentary. Typically, the employee may sit comfortably to do the work. However, there may be some walking; standing; bending; carrying of light items such as papers, books, small parts; driving an automobile, etc. No special physical demands are required to perform the work.

Security Clearance

Public Trust - Background Investigation

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