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Patient Services Assistant

1 month ago

Fargo, United States Veterans Health Administration Full time

***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.

Work Schedule:
Monday - Friday, 8:00am - 4:30pm


Recruitment & Relocation Incentives:
Not authorized


Financial Disclosure Report:
Not Required