Lead Medical Support Assistant

U.S. Department of Veterans Affairs; Columbia (SC); On-site; USD 52,000 - 66,000; Full time

Job summary

The Lead Medical Support Assistant GS-7 at the Columbia VA Health Care System provides administrative support for Enrollment & Eligibility across multiple clinics and communities.

You will review VA health benefit applications, coordinate scheduling, maintain records, and guide Veterans through eligibility and enrollment processes, while ensuring compliance with HIPAA and related policies.

Qualifications

• Advanced knowledge of medical terminology and clinic flow across multiple clinics.

Responsibilities

• Independently reviews and adjudicates VA health benefit applications.
• Verifies eligibility using VES, HEC, VIS, MPI Toolkit and related systems.
• Resolves complex alerts and guides Veterans through enrollment procedures.
• Oversees appointment scheduling, cancellations, and consult management.

Skills

Advanced medical terminology

Interdisciplinary communication

Staff development and training

Clerical workflow management

Education

One year above high school

Tools

Vista

CPRS

VES

MPI Toolkit

VIS

Job description

Summary

The incumbent is assigned to the Eligibility and Enrollment Section of the Business Office at the Columbia VA Healthcare System at the following locations: Columbia - Sumter - Orangeburg - Spartanburg - Rock Hill - Anderson - and Florence County. The Lead Medical Support Assistant is responsible for the administrative support of the clinical services to include Primary Care and various Specialty Clinics located in the Community Based Outpatient Clinics.

Summary

The incumbent is assigned to the Eligibility and Enrollment Section of the Business Office at the Columbia VA Healthcare System at the following locations: Columbia - Sumter - Orangeburg - Spartanburg - Rock Hill - Anderson - and Florence County. The Lead Medical Support Assistant is responsible for the administrative support of the clinical services to include Primary Care and various Specialty Clinics located in the Community Based Outpatient Clinics.

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy
• English Language Proficiency: Applicants appointed to direct patient care positions must be proficient in spoken and written English
• Experience: Six months experience of clerical - office or other work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position
• OR Education: One year above high school
• OR Experience/Education Combination: Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable
• 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)
• Grade Determinations: For GS-7 (Lead Medical Support Assistant) - In addition to the basic requirements - candidates must have the following: Examples of specialized experience include - but are not limited to the following: Coordinating with the patient care team to review the clinic utilization by using various reports (e.g. - Clinic Utilization Statistical Summary) - ensuring that the clinic setup is closely monitored to effectively support the needs of the clinic - and make any necessary adjustments
• developing/maintaining effective and efficient communication with the patient - interdisciplinary team - VA medical centers - and other agencies (e.g. - assist with communications during the inpatient to outpatient discharge
• communicate with non-VA medical facilities
• facilitate/process secure messaging with the patient and team
• notify patients of normal lab results
• develop and manage a tracking system for follow up care such as consults - tests - etc.)
• technical competency in the use of Vista and CPRS systems is required
• must have knowledge of eligibility for VA medical care - priorities for care - release of information - Health Information Portability and Accountability Act (HIPAA) Laws - and the Medical Fee Basis programs
• must have knowledge of and be able to provide information about VA Medical Care Cost Recovery Program to patients regarding insurance data collection and revenue collection
• participating in team meetings to manage and plan patient care
• setting priorities and deadlines for the team - adjusting the flow and sequencing of the work to meet team and patient needs
• monitoring pre-appointment requirements to assure readiness for patient visit/procedure (e.g. - X-ray - lab work)
• managing electronic wait list to verify and validate accuracy and resolve issues
• performing administrative follow up actions
• participating in and independently following up on team huddles by sharing information and collaborating with the medical team to assure continuity of care
• evaluating patient information and clinic schedule lists to determine whether patient is vested
• educating providers about shared patients (those who receive their care at multiple VAs or those who have care in the community) and bringing to the attention of the provider
• Lead Medical Support Assistants at this level must demonstrate ALL of the Knowledge - Skills - and Abilities (KSAs) below
• If selected for the position response to the KSAs need to be completed on plain paper - with a narrative description of experience - education - and training as it relates to each KSA
• Advanced knowledge of medical terminology and a wide range of clinical flow processes relating to access to care across multiple clinics - specialties - and/or community resources
• Ability to utilize numerous advanced patient systems in support of multiple clinics in an interdisciplinary setting
• Ability to organize work - set priorities - and delegate tasks/responsibilities in order to meet deadlines
• Skill in communicating with individuals to obtain the desired effect and coordinating with a variety of interdisciplinary care team staff
• Ability to provide staff development and training
• Ability to manage staffing requirements - manage workflow priorities - and adjust the flow of work to meet team and patient needs
• This includes the ability to follow-up on pending issues and demonstrate an understanding of the impact of incomplete work across multiple clinics
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• The full performance level of this vacancy is GS-7. Physical Requirements: The work of the positions is primarily sedentary however - some walking - standing - bending stooping and carrying of small items such as files may be required.

Duties

• VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo The Lead Medical Support Assistant - GS-7 - assigns the daily workload and provides training to the Advanced Medical Support Assistant staff as they are the expert administrative and technical support for Enrollment & Eligibility - Admissions - Beneficiary Travel - My HealtheVet - Community Care - and VBA within the Columbia VA Health Care System
• The Lead Medical Support Assistant (MSA) works independently and is considered the chief source of patient information and plays an important role in accomplishing the administrative work within the outpatient clinics by the duties listed below: Independently reviews - adjudicates - and authorizes VA health benefit applications
• Applies extensive knowledge of federal laws - VHA directives - and special emphasis programs (PACT Act - Caregiver - OEF/OIF/OND - ACA - Agent Orange - Camp Lejeune - HUD-VASH - and others)
• Verifies eligibility using VES - HEC - VIS - MPI Toolkit - and related systems
• resolves complex HEC alerts
• Provides expert guidance to Veterans on required documentation - eligibility criteria - and enrollment procedures
• Updates demographic - insurance - military service - and income information
• ensures accuracy for billing and workload credit
• Oversees appointment scheduling - cancellations - and consult management following VHA directives
• Performs same-day consult actions - ensuring accuracy within DST and consult toolbox systems
• Ensures appropriate disposition of consults - including documentation for consults older than 90 days
• Serves as a key point of contact for Veterans - staff - and external partners
• resolves complex inquiries
• Coordinates Veteran transportation concerns Veterans Transportation Service
• Models professional - culturally-competent customer service and supports Veteran-centered care
• Ensures high-level accuracy of eligibility and enrollment data across multiple systems
• Oversee document routing to HIMS for scanning
• ensures compliance with record-keeping standards
• Generates and reviews reports for unverified applications - incomplete encounters - or administrative errors
• Performs other duties as assigned
• Work Schedule: 8:00am to 4:30pm - Monday-Friday Virtual: This is not a virtual position
• Functional Statement #: 63466F Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized