Legal Administrative Specialist

Duties

Apply below after reading through all the details and supporting information regarding this job opportunity.

This position functions as a Claims and Service Specialist (CSS) Legal Administrative Specialist.

The incumbent performs work in the areas of community care coordination and payment of claims related to care in the community to administer benefits and to resolve concerns from Veterans and non-VA providers.

Duties include management of claims and conducting reviews as required by their direct supervisor. The primary purpose of this position is to improve the Veteran and non-VA provider experience with care in the community.

• The position is expected to perform a variety of support service functions and related work in dispersing information to the public on rights, benefits, privileges, or obligations;
• explaining pertinent legal provisions, regulations, and related administrative practices, and their application to specific cases;

and assisting individuals in developing needed evidence and preparing required documents to process claims, or in resolving errors, delays, or other problems in obtaining benefits or fulfilling obligations.

Performs work to facilitate claims payment and customer service by examining Veteran's medical records, community care authorizations, community payment records, and historical tracking of submitted health care claims.

Conducts performance reviews to determine the economy, efficiency, and effectiveness of program operations and to determine whether the entity has complied with laws and regulations applicable to the program.

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 : Required to work Monday through Friday, TBD upon selection

Compressed / Flexible : Available - TBD upon successful completion of orientation

Telework : Available after successful completion of a 90-day on-site orientation

Remote : This is not a remote position.

Virtual : The employee may work at the VA facility or other VA-leased space at an address specified in this announcement that is hiring the employee and is authorized for telework up to 50%, after successful completion of a 90-day on-site orientation .

Position Description / PD# : Legal Administrative Specialist / PD13073A and PD13072A

Relocation / Recruitment Incentives : Not Authorized

Critical Skills Incentive (CSI) : Not Approved

Permanent Change of Station (PCS) : Not Authorized

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