The position is located within a CPAC, organizationally aligned under the Chief Operating Officer, with the Incumbent serving as the Insurance Verification Manager for the first and third party Revenue Program (MCCF) and Pharmacy Team.
Serves as the local CPAC's technical authority on the VHA's Insurance Verification, Pre-registration and Pharmacy Claims Processing departments and the interface with intake business processes at the medical center. Directs the development of the most critical and complex MCCF diagnostic measures reporting mechanisms to showcase and spotlight areas in need of improvement, or areas that have excelled in reporting.
Advises the CPAC Program Managers' of potential areas of concern and process breakdowns impacting insurance data capture and pharmacy claims processing with recommendations for improvement.
Implements and manages all aspects of insurance verification activities for CPAC clients including the E-IIV program, contractor sourced new insurance uploads, routine verification and re-verification of patient specific insurance coverage: pre-registration of patients with scheduled admissions and ambulatory procedures prior to appointment, processing (data entry and verification) of newly identified insurance card data and the entire pharmacy claims processing including; billing, EOB review, accounts follow-up and closure.
Provides management oversight, guidance, and direction for monitoring activities designed to ensure the integrity and accuracy of insurance information contained on healthcare claims. Develops, implements, and evaluates management procedures in order to enhance provider relations and productivity. Performs analysis of workload, patient service, and similar data to forecast future needs of the CPAC and initiates the necessary action to ensure efficient service delivery.
Establishes and maintains effective working relationships with others throughout the organization as well as externally. These include high ranking Department of Veterans Affairs officials, officials of other Government agencies, members of the public as well as colleagues and subordinates. Plans work to be accomplished by subordinates, and establishes and adjusts long and short term priorities and deadlines.
Assigns work based upon program priorities, capabilities, and assignment requirements. Establishes standards for the performance of work. Conducts periodic evaluations of the work performance of subordinates. Provides advice, counsel or instructions to employees on administrative and technical matters. Designs, plans, schedules and conducts studies and organizational strategies to identify opportunities to improve customer service and quality.
Facilitates the innovative application of industry and agency best practices and quality management methods. Performs other directly related duties as assigned. Work Schedule: Monday - Friday, 8:00 am - 4:30 pm Compressed/Flexible: May be available at supervisors discretion Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position.
Financial Disclosure Report: Not required
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://www.ed.gov/about/initiatives/international-affairs/recognition-of-foreign-qualifications
VHANationalRecruitmentCenter@va.gov · (844)456-5208
This position is with Veterans Health Administration, Department of Veterans Affairs.
The posted pay range is $75897 – $98671/yr.
This position is eligible for telework.
Applications close on 2026-09-21.
This position is open under the 'Fed Transition' hiring path.
Source: USAJOBS.gov — U.S. Federal Government
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