Summary This position is located in a Consolidated Patients Account Center (CPAC) in the organization of the Deputy Director of Operations, serving as the Facility Revenue Manager (FRM) located on-site at a medical facility. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by consolidation of billing and collection activity supported by medical center based utilization review, data validation and customer service functions. Responsibilities Major Duties include, but are not limited to: Monitors changes in eligibility that support the need to reset medications where the individual is no longer medication co-payment required. Monitors that individuals are credited for prescriptions filled at facilities for the purpose of the yearly co-payment cap by completing the Push Rx Copay Cap transaction. Monitors Held Charges and Days on Hold to ensure that co-payments are released timely and appropriately. Develops and provides monthly reports to management and various departments. Monitors the closing and creation, set-up, naming conventions and stop code assignments of new clinics within a facility and determines their designation as High Dollar such as surgeries, chemotherapy, dialysis, etc. Reviews clinical information and obtains third-party insurer authorization for continuation of care and payment. Keeps abreast of clinical activities that have the potential to negatively affect revenue. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday - Friday, 8:00 AM - 4:30 PM Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Financial Management Specialist/PD57798A and PD87429A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized 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, 12/27/2024. 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-9 position you must have served 52 weeks at the GS-7. For a GS-11 position you must have served 52 weeks at the GS-9. 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. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below: Specialized Experience (GS-9): You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Coordinating and managing daily operations of revenue functions. Assessing the financial position of the revenue program and areas affecting revenue generation. Performing auditing duties associated with either financial or operational audits of the revenue program and reviews the program's degree of compliance with sound fiscal internal control and quality management. Advises and consults with counterparts and/or officials with higher authority concerning problems involving work in the revenue program and its' impact on broader programs, education, training needs for staff and training problems affecting the unit and other related programs. Performing quality reviews to ensure staff are completing workloads accurately and timely based on acceptable standards. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent degree or 2 full years of progressively higher level education leading to such a degree or LL.B or J.D., if related. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and graduate level education. Only graduate education in excess of the amount required (1 full year) for the next lower grade level may be used to qualify. Specialized Experience (GS-11): You must have one year of specialized experience equivalent to at least the next lower grade GS-9 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Coordinating and managing daily operations of revenue functions. Assessing the financial position of the revenue program and areas affecting revenue generation. Performs auditing duties associated with either financial or operational audits of the revenue program and reviews the program's degree of compliance with sound fiscal internal control and quality management. Advising and consulting with counterparts and/or officials with higher authority concerning problems involving work in the revenue program and its' impact on broader programs, education, training needs for staff and training problems affecting the unit and other related programs. Performs quality reviews to ensure staff are completing workloads accurately and timely based on acceptable standards. Developing and implementing programs to effectively manage patient accounts, identifying potential billable cases and optimizing collections. Preparing reports that identify noncompliance with regulations, inefficient operations or improper practices and developing constructive recommendations for improvements within the audit segment. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level education leading to such a degree or LL.M., if related. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond 2 years of graduate level education. Only graduate education in excess of the amount required for the next lower grade level may be used to qualify. You will be rated on the following Competencies for this position: Communication Leadership Technical Competence Performance Measurement Analysis and Problem Solving 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: Duties are primarily performed in an office setting and are mostly sedentary with some physical exertion, such as walking, bending, stooping, and stretching. 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 A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. 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. This job opportunity announcement may be used to fill additional vacancies. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.