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Contact Representative

Company: Department of Veterans Affairs
Location: North Chicago
Posted on: May 3, 2021

Job Description:

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Duties

Summary

The primary purpose of this position is to complete specialty care referral reviews, coordinate with other health care systems, track referrals, process medical records and perform chart reviews according to Joint Commission. Additionally, the position provides specialized information and assistance for all categories of beneficiaries involved in the patient referral and authorization process throughout the delegated 16 State Region catchment area.

Learn more about this agency

Responsibilities

Major Duties:

  • Scans the Clear Legibility Report (CLR) in to Electronic Health Record (EHR) and administratively closes consult.
  • Ensures Personally Identifiable Information (PII) is protected in accordance with federal and facility guidelines,
  • Ensures Unique Identifier Number (UIN) of referral data in CLR matches in EHR.
  • Notifies ordering providers of CLR via note within EHR system.
  • Manages referral tracking database to ensure completion of consults and delivery of CLR to ordering provider.
  • Utilizes various computer software applications for processing of specialty care referral reviews, health care system coordination, tracking referrals, processing medical records, and chart reviews.
  • Submits telephone consultations and contacts health care organizations regarding the TRICARE CLR process.
  • Provides specialized information and assistance for all categories of beneficiaries involved in the patient referral and authorization process.
  • Responsible for requesting CLRs from civilian network rendering providers when clinically indicated and notified by requesting provider/clinic.
  • Adheres to a standardized, enterprise-wide approach to track and account for referrals deferred to the network and right of first refusals (ROFRs) accepted by FHCC.

Work Schedule: Monday-Friday 7:30am-4:00pm

Telework: Not available.

Virtual: This is not a virtual position.

Position Description/PD#: Contact Representative/PD06128A

Relocation/Recruitment Incentives: Not Authorized

Financial Disclosure Report: Not required

Travel Required

Not required

Supervisory status

No

Promotion Potential

None

  • Job family (Series)

0962 Contact Representative

  • Requirements

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Requirements

Conditions of Employment

  • You must be a U.S. Citizen to apply for this job
  • Designated and/or random drug testing may be required
  • 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

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 05/04/2021.

You may qualify based on your experience and/or education as described below:

  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Reviewing documents for accuracy, coordination of administrative duties, tracking or administrative actions and customer service.

OR

  • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 4 years of education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite.

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 the first 60 semester hours.

You will be rated on the following Competencies for this position:

  • Attention to Detail
  • Computer Skills
  • Customer Service
  • Information Assurance

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: In most assignments the work is sedentary. However, there is walking among clinics within the facility with some bending, carrying, filing documents, delivering documents, and administrative task related to the operations of referral management section.

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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Keywords: Department of Veterans Affairs, Waukegan , Contact Representative, Other , North Chicago, Illinois

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