The Community Care Scheduling AMSA conducts scheduling of Non-VA medical appointments when services are not available or cannot be provided cost effectively at a VA facility including coordinating with the private sector to authorize and schedule care, clinical documentation management, correspondence to the veteran and community providers, tracking of pre/post appointment follow-ups. Receives consult requests for long/short-term authorization of outpatient fee basis community care.
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. Experience and Education: Experience. Six months experience of clerical, office, customer service, or other administrative 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; (A transcript must be submitted with your application if you basing all or part of your qualifications on education) OR, Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. English Language Proficiency: MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.j. 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 Requirements In addition to the basic requirements for employment listed above, the following education and experience criteria must be met: Advanced Medical Support Assistant, GS-6 Experience: One year of experience equivalent to the GS-5 grade level. The required specialized experience for this position includes: performing a full range of duties related to the delivery of healthcare services in an inpatient or outpatient setting, advises clinical staff on administrative processes, scheduling appointments, monitoring appointment requests from multiple electronic sources, verifying and updating demographics and insurance information, and coordinating administrative functions. Demonstrated Knowledge, Skills, and Abilities: Candidates must also demonstrate all of the following KSAs: Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. 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-6 Physical Requirements: The work is sedentary. While working in the clinic, physical demands include walking, getting up and down from sitting to retrieve various items and carrying items such as papers, folders, belongings, etc. Crouching and bending are required to file documents and attend to supply needs. Although constant demands, such as continually ringing telephones and continual work interruptions by staff and patients, sometimes make it very difficult for the medical support assistant to leave the work area for even a short period of time. No special physical demands are required to perform the work.
Major duties of the Advanced Medical Support Assistant (AMSA) include, but are not limited to: Initiates/prepares automated authorization for medical and hospital services to include appropriate explanation of VA guidelines. Ensures completed authorization is mailed/faxed to appropriate veterans and providers. Performs "validity reviews" (follow up) of long-term and short-term authorizations to determine the need for continued community care. Notifies veteran of review and requests information from veteran and physician. Ensures that necessary information is received and prepares information and recommendation for submission of continuation or discontinuation of community care. Must create an authorization for care, utilizing the HSRM software. Must also upload/transfer that authorization to third party administrator. Composes letters and provides verbal assistance to a variety of individuals regarding the application/approval/appellate processes involved. Responsible for editing of patient data and authorizations in CPRS/HSRM to reflect changes in status of existing authorizations, such as address changes, cancellations, reinstatements, corrections, or other types of alterations. Cancels community care consults when notices are received and conducts an effective office environment which promotes the efficiency of program operations, creates the tone for a positive customer response to our organization, and enhances the public image of the medical center with external customers. Advises sharing beneficiaries of basic eligibility, covered and non-covered services, and program requirements with the thorough knowledge of all component programs. This will include making eligibility determinations based on the customer's status, enrollment, and services required and/or requested. Utilizes a full range of office automation skills and techniques (i.e., word processing, spreadsheets, graphics, data base management, etc.) in order to assist in providing clerical, administrative, and program support. Provides personal and hands-on customer services to beneficiaries/customers requesting information or receiving health care services. Prepares and initiates necessary reports, graphic presentations, and correspondence independently in support of the program goals and objectives. Interfaces with and assists the clinical providers in coordinating certain administrative details (i.e., authorizations), appointment scheduling, and clinic consult services. Works with clinical partners to ensure consult content is appropriate, orders are complete, and care is routing to appropriate providers in the community. Composes routine and technical correspondence at the direction of the Health Systems Specialist and Office of the Director. Acts as a liaison to coordinate information between the referring MD, Community Care Nurses and the receiving facility, the patient, the family, and the medical services with the VA Montana Healthcare System, to access, promote, and ensure maximum continuity of care. Communicates with physicians and community provider scheduler personnel to schedule patients for outpatient clinic appointments as needed. VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELoTotal Rewards of a Allied Health Professional Work Schedule: Monday - Friday 8:00am - 4:30pm or as agreed upon with the possibility of extended hours and weekends. Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Telework: Not Authorized Functional Statement #: 436-51755-A