Medical Support Assistant

01Basic Requirements

United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Experience and Education. (1) Experience. Six months experience of clerical, office, [customer service], or other [administrative] work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR, (2) Education. One year above high school; OR, (3) Experience/Education Combination.

Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. Foreign Education. To be creditable, education completed outside the U.S. must have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and such education must have been deemed at least equivalent to that gained in conventional U.S. programs. English Language Proficiency.

MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.j. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grandfathering Provision.

All MSAs employed in VHA in this occupation on the effective date of this qualification standard (August 1, 2019) are considered to have met all qualification requirements for the title, series, and grade held, [which] are [a] part of the basic requirements of the occupation.

For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply: (1) Such employees may be reassigned, promoted, or [changed to a lower grade] within the occupation. (2) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis, until they fully meet the basic requirements of the standard. (3) If an employee who was converted to Title]38 hybrid status under this provision leaves the occupation, the employee loses protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation.

Grade Determination: Medical Support Assistant, GS-5 (Full Performance Level): To qualify candidates must meet either: Experience: One year of experience equivalent to the GS-4 grade level which includes, but not limited to scheduling and rescheduling patients for treatment; interviewing patients for appointments; referring patients to other medical specialty clinics; providing information to patients necessary to resolve VA Handbook complaints; interacting with both internal and external customers; reviewing and documenting medical outpatient and inpatient electronic health records, as well as administrative records; verifying third party insurance and updating information in the Insurance Capture Buffer (ICB) system; obtaining medical information from patients; coordinating information and actions related to patient care and services; and scheduling appointments in accordance with VHA national scheduling guidelines. [MSAs at this level refer all questions regarding medical attention to the appropriate health care team member.

OR, 2. Education. Four years of education above high school; AND Candidates must demonstrate all of the KSAs below: Ability to operate computerized programs and systems in order to enter, modify, and retrieve sensitive medical and patient identifying information (PII) into or from electronic health records, scheduling systems, and/or reports. Advanced knowledge of medical terminology specific to understand medical diagnosis and procedures sufficient to communicate clinical staff instructions to patients.

Ability to [schedule medical] appointments in a clinical setting. Ability to work independently in the accomplishment of a wide variety of duties performing patient support work Ability to communicate effectively and professionally in person, electronically, and/or by telephone, with internal and external customers. Skill in customer service with the ability] to identify customer concerns, and refer to the appropriate staff, as necessary, to ensure a satisfactory resolution.

References: August 1, 2019 VA HANDBOOK 5005/117 PART II APPENDIX G45The full performance level of this vacancy is GS-5. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-3 to GS-5.Physical Requirements: Operate a computer terminal and be able to manage multiple activities at one time. Work is generally sedentary; however, there may be some walking, standing, bending, and carrying of light items.

Work Environment: The work may be stressful due to the accelerated pace for several hours at a time during peak hours or on days that have a large volume of activity. See VA Directive and Handbook 5019.

The MSA works collaboratively in an interdisciplinary coordinated care delivery model and assists the clinical providers in coordinating certain administrative details, appointment schedules and clinic consult services; customer service and other duties assigned for the proper and timely treatment of patients and maintain appointment schedules for multiple services.

Duties include but are not limited to: Responsible for answering phones, greeting patients, relaying messages to appropriate staff inside or outside of the unit, scheduling appointments, including interpreting and verifying provider orders in accordance with VHA national scheduling guidelines. Scheduling, canceling, re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources.

Participating in huddles with other MSAs and/or clinic staff to determine the daily needs of the clinic. Monitoring both inpatient and outpatient appointments in areas of responsibility. Verifying and updating demographics and insurance information when patients check-in for appointments.

Coordinates administrative functions relating to emergency and non-emergency transfers to other VA facilities or private hospitals and determines appointment type based on the patient's eligibility status, (i.e., TRICARE, sharing agreement, collaterals, research patient, VA employee, etc.) Supports patient safety standards using the correct Veterans Affairs identification of all patients using two forms of identification, name and full Social Security Number.

He/she must use each interaction with the patient to validate and update patient demographic information, to decrease the incidence of returned mail due to incorrect addresses and inability to contact patient by phone due to incorrect number. Explains the VA's mandate to collect insurance information to veterans, their families, and other eligible patients.

Promotes veteran registration for and utilization of My HealtheVet (MHV).As first line contact with patients and staff, the incumbent sets the tone for perception concerning quality of healthcare services at the VA. A high degree of tact and diplomacy is required when dealing with veterans who have multiple health problems and who may be frustrated with the administrative process associated with diagnosis and treatment.

A caring, compassionate and sensitive manner is essential when explaining procedures to veterans and their family members. Ensure that all necessary health/administrative information are integrated into Computerized Patient Record System (CPRS) by sending the documents to scanning. Screen/receive phone calls in a courteous and timely manner, determine the nature of requests and provide the information desired using privacy rules and established processes.

Responsible for generating authorizations for pre-authorized outpatient, unauthorized, inpatient and emergency care claims, while making eligibility determinations for the various programs in Community Medical Care.

Required fund of knowledge for generation of authorizations is multi-faceted in that incumbent must generate authorizations across several systems: the Veterans Health Information Systems and Technology Architecture (VistA), the Fee Basis Claim System (FBCS), Computerized Patient Record System (CPRS) and Health Share Referral Manager (HSRM). Works closely with utilization review to ensure proper authorizations are issued and appropriate correspondence is sent to vendors.

Acts as a liaison between the veteran and the vendors with regard to Community Medical Care section and VA clinical services and/or primary care services. Utilizes FBCS and VistA to manage and coordinate appointment management with the creation of authorizations as outlined by the Community Care Coordination national SOPs. Works to resolve issues with veterans, vendors and clinical staff to ensure appropriate care is scheduled and authorized at Community Care facilities.

Work Schedule: 8:00 AM - 4:30 PM Monday - Friday (schedules will vary; may be required to work weekends, evenings, and holidays depending on department need) Compressed/Flexible: Not Authorized Telework: Not Authorized Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required