Patient Services Assistant

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION***

Duties include but may not be limited to:

• Establishes legal entitlement to determine eligibility of applicants for healthcare benefits.
• Obtains and reviews insurance policies and plans.
• Serves as the key contact for veterans seeking guidance with eligibility inquiries, which may be regular and recurring contacts.
• Conducts interviews with applicants and family representatives to establish medical eligibility.
• Ensures documentation is obtained, verifying eligible medical and/or dental services can be provided.
• Interprets and explains issues such as deductibles, co-payments, length of stay and other matters to applicants.
• Investigates 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.
• Prepares eligibility notification documents regarding health and/or dental care qualifications.
• Communicates insurance and program information to eligible patients and explains denial of benefits in a diplomatic, professional manner.
• Prepares and forwards inquiries to the Regional Office for establishing eligibility and/or verifying service information to continue the process of the application.
• Processes applications received that are determined ineligible for VA Health Care.
• Manages the means testing and copay exemption test program.
• Utilizes a variety of office equipment and automated software.
• Performs other duties as assigned.