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.
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/18/2025. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-05 position you must have served 52 weeks at the GS-04. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify 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. Transcripts must be submitted at time of application. 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. Transcripts must be submitted at time of application.To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-05. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position 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: Administrative Law Clerical Communications Computer Skills 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/.
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 asses 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. Financial Disclosure Report: Not required. Bargaining Unit Position: Yes, covered 1272 AFGE. The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.