Summary
The position is located within the VHA Revenue Operations, North Central Consolidated Patient Account Center (NCCPAC), organizationally aligned under the Director, with the position serving as the Payer Relations Manager for the NCCPAC. The Consolidated Patient Account Center (CPAC) is one of seven regionally consolidated business entities established to enhance revenue operations throughout the VISN networks and across the Veterans Health Administration system.
This job is open to
- Career transition (CTAP, ICTAP, RPL)
Federal employees who meet the definition of a “surplus” or “displaced” employee.
- Internal to an agency
Current federal employees of this agency.
Clarification from the agency
Open to current permanent employees of the Department of Veterans Affairs.
Videos
Duties
- Expert authority on revenue processes as they relate to third-party payer (TPP) agreements and will provide advice and recommendations necessary to identify opportunities for improvement in the recovery of TPP payments for medical services provided by the Veterans Health Administration (VHA) to veteran beneficiaries.
- Responsible for improving revenue collections and collection productivity by implementing tools and strategies related to TPP billing and collection activities.
- Leverages national standards and industry best practices to verify that operational processes are effective, efficient and compliant with federal regulations. Reviews data and revenue performance trends, participates in policy and decision-making initiatives, and continuously develops a greater understanding of regulatory and policy requirements, managed care reimbursement theories and collections best practices for the CPAC.
- Oversees operational alignment between VHA revenue operations capabilities and TPP agreement terms and payer policies and requirements.
- Leads discussions with payers to facilitate resolution of systemic TPP collections issues.
- Provides guidance and support to junior Payer Relations staff and assist in directing their work.
VA offers a comprehensive total rewards package: Total-Rewards-of-a-Nonclinical-Professionals-VA-Career-Brochure.pdf
Work Schedule: Monday through Friday, 7:30am to 4:00pm
Compressed/Flexible: Flexibility in the scheduled duty hours may be available.
Telework: May be suitable for some days per pay period based on proficiency.
Virtual: This is not a virtual position.
Position Description/PD#: Sup Financial Admin Spec/PD83171A
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized.
Financial Disclosure Report: Not required.
Requirements
Conditions of Employment
- You must be a U.S. Citizen to apply for this job
- Selective Service Registration is required for males born after 12/31/1959
- You may be required to serve a probationary period
- Subject to background/security investigation
- Selected applicants will be required to complete an online onboarding process
- Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
- Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) – See “Additional Information” below for details.
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/25/2023.
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-12 position you must have served 52 weeks at the GS-11. 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.
You may qualify based on your experience as described below:
Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS 11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:
1) Conducts on-going monitoring of contracted and non-contracted third-party payer payment trends and reimbursement compliance utilizing existing systems and reporting tools in collaboration with Accounts Management.
2) Facilitates implementation of strategies for resolving the root cause of systemic contracted and non-contracted third-party payer issues and reimbursement disputes to reduce days in accounts receivable, claims denials and reimbursement errors.
3) Obtains and posts third-party payer agreement terms and conditions updates, including reimbursement rate profiles, into the third-party payer Agreement Information Tool in a timely manner for use by Billing, Denials Management and Accounts Management staff.
4) Leads meetings with payers to educate them on federal regulations governing reimbursement and with key revenue contacts within VHA to provide recommendations for revenue operations enhancements and to facilitate the resolution of systemic revenue issues.
5) Effectively prepares and presents individual and/or group briefings to senior leadership on a wide range of revenue operations and reimbursement related topics impacting or impacted by third-party payer agreements, including supporting data and analytics.
6) Monitors claim performance data and compares reimbursement to third-party payer agreements to identify and provide root cause resolution recommendations to resolve current and mitigate future under and overpayments.
7) Assigns work to subordinates based on priorities, selective consideration of the difficulty and requirements of assignments and the capabilities of employees.
You will be rated on the following Competencies for this position:
- Analytical Reasoning
- Communication
- Compliance
- Conflict Management
- Education and Training
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 primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort.
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/.
Education
There is no educational substitution at this grade level.
Additional information
Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.
The Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about CTAP eligibility is on OPM’s Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.
This job opportunity announcement may be used to fill additional vacancies.
- Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.
Narrative responses are not required at this time. If you are referred for consideration, you may be asked to submit additional job related information, which may include, but not limited to; responses to the knowledge, skills and abilities; completion of a work sample, and/or contact for an interview. Your resume and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.
The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate’s abilities; and assist a hiring manager with making a final selection for a position.
For more information on the “Who may apply” eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document.
Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
- Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
- Required Documents
As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have – whether you’re a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you’re eligible under their policies.
To apply for this position, you must provide a complete Application Package which includes:
- Resume
- SF-50/ Notification of Personnel Action
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50’s (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
- Cover Letter
- Performance Appraisal
- Resume
- Separation Notice (RIF)
- SF-50/ Notification of Personnel Action
SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
- Most recent SF-50 if you are a current or former Federal employee
- An SF-50 showing 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
- Award 50’s do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
- Examples of appropriate SF-50’s include:
- Within grade increases at the highest grade held; or
- Promotions with an effective date more than one year old; or
- SF-50’s at the highest grade held with an effective date more than one year old.
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
- How to Apply
All applicants are encouraged to apply online. To apply for this position, you must complete the questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 09/25/2023 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12007541.
- To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
- Click Submit My Answers to submit your application package.
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.
Agency contact information
VHA National Recruitment Center
Phone
(844)456-5208
Email
VHANationalRecruitmentCenter@va.gov
Address
VA NCCPAC Madison 8001 Terrace Ave Middleton, WI 53562 US
Next steps
Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
- Fair and Transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
- Equal Employment Opportunity (EEO) Policy
- Reasonable accommodation policy
- Financial suitability
- Selective Service
- New employee probationary period
- Signature and false statements
- Privacy Act
- Social security number request
Required Documents
To apply for this position, you must provide a complete Application Package which includes:
- Resume
- SF-50/ Notification of Personnel Action
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50’s (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
- Cover Letter
- Performance Appraisal
- Resume
- Separation Notice (RIF)
- SF-50/ Notification of Personnel Action
SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
- Most recent SF-50 if you are a current or former Federal employee
- An SF-50 showing 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
- Award 50’s do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
- Examples of appropriate SF-50’s include:
- Within grade increases at the highest grade held; or
- Promotions with an effective date more than one year old; or
- SF-50’s at the highest grade held with an effective date more than one year old.
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
How to Apply
All applicants are encouraged to apply online. To apply for this position, you must complete the questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 09/25/2023 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12007541.
- To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
- Click Submit My Answers to submit your application package.
NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Application page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.
Agency contact information
VHA National Recruitment Center
Phone
(844)456-5208
VHANationalRecruitmentCenter@va.gov
Address
VA NCCPAC Madison 8001 Terrace Ave Middleton, WI 53562 US
Next steps
Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
Fair & Transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
- Equal Employment Opportunity (EEO) Policy
- Reasonable accommodation policy
- Financial suitability
- Selective Service
- New employee probationary period
- Signature and false statements
- Privacy Act
- Social security number request