Legal Administrative Specialist (Contact Representation)

Duties Communicate guidelines and policy updates to military health systems beneficiaries and staff members.
Input various case data into automated systems for tracking and statistics.
Manage patient and provider aspects of the Tricare program including health benefits counseling, resolution of claims, debt collections and patient and provider education.
Interpret health benefits, reimbursement policies, and claims processing guidelines and procedures.
Ability to effectively communicate orally and in writing with civilian providers offices, collection agencies and other governmental agencies regarding claims resolution issues.
Develop operating instructions and guidelines for clarification of public law and policies.
Provide program management, analysis and policy formulation for the DoD Tricare managed care program.
Requirements Conditions of Employment Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
A Personnel Security Investigation is required.
Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption.
Immunization screening is required.
Hepatitis B immunization is required for all positions with direct patient contact.
Applicants may be required to show proof of other immunizations depending on the type of position.
Qualifications Who May Apply: US Citizens In order to qualify, you must meet the qualification requirements described below.
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; religious; spiritual; community; student; social).
You will receive credit for all qualifying experience, including volunteer experience.
Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application.
Additional information about transcripts is in this document.
Specialized Experience: I have one year of specialized experience equivalent to the GS-07 grade level in the Federal services which includes providing guidance on various healthcare policies or plans; and counseling beneficiaries concerning specialized health plan information, benefits, or services.
OR Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree in a field which demonstrates the knowledge, skills, and abilities necessary to do the work of the position, such as Healthcare Administration or Business Administration.
(Note: You must attach a copy of your transcripts).
OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%.
To compute the percentage of the requirements, divide your total months of experience by 12.
Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18.
Add the two percentages.
(Note: You must attach a copy of your transcripts).
You will be evaluated on the basis of your level of competency in the following areas: Administration and Management Customer Service Manages and Organizes Information Education FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.
S.
education program; or full credit has been given for the courses at a U.
S.
accredited college or university.
For further information, visit: https://sites.
ed.
gov/international/recognition-of-foreign-qualifications/.
Additional information Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
You will be required to provide proof of U.
S.
Citizenship.
One year trial/probationary period may be required.
Direct Deposit of Pay is required.
Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
Recruitment or relocation incentives MAY be authorized for highly qualified candidates.
Multiple positions may be filled from this announcement.
Salary includes applicable locality pay or Local Market Supplement.
If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.
Benefits Review our benefits How You Will Be Evaluated You will be evaluated for this job based on how well you meet the qualifications above.
Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement.
If you are minimally qualified, your resume and supporting documentation will be compared against your responses to the assessment questionnaire to determine your level of experience.
If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position.
Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.
You should list any relevant performance appraisals and incentive awards in your resume as that information may be taken into consideration during the selection process.
If selected, you may be required to provide supporting documentation.
Basis for Rating: Qualified candidates will be assigned to one of three quality categories: Best Qualified, Highly Qualified and Qualified.
Veteran preference eligibles are listed ahead of non-preference eligibles within each quality category.
Best Qualified.
Candidates in this category possess exceptional skills and experience to exceed well above the minimum requirements for the announced position.
Highly Qualified.
Candidates in this category possess good skills and experience above the minimum requirements for the announced position.
Qualified.
Candidates in this category meet the minimum experience requirements for the announced position.
You may claim Military Spouse preference.
You may claim Priority Placement Program (PPP) preference.
Interagency Career Transition Assistance Program (ICTAP).
If you are a Federal employee in the competitive service and your agency has notified you in writing that you are a displaced employee eligible for ICTAP consideration, you may receive selection priority for this position.
To receive selection priority, you must: (1) meet ICTAP eligibility criteria (2) be rated well-qualified for the position and; (3) submit the appropriate documentation to support your ICTAP eligibility.
To be considered well-qualified and receive selection priority applicants must satisfy all qualification requirements for the position and receive a score of 90 or above.
Additional information about the program is on OPM's Career Transition Resources website.
Benefits Review our benefits Required Documents As a new or existing federal employee, you and your family may have access to a range of benefits.
Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee.
You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.
The documents you are required to submit vary based on whether or not you are eligible for preference in federal employment.
A complete description of preference categories and the associated required documents is in the Applicant Checklist for Public Announcements.
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply.
If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1.
Your resume: Your resume may be submitted in any format and must support the specialized experience described in this announcement.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations and you may not be considered for this vacancy.
For qualifications determinations your resume must contain hours worked per week and the dates of employment (i.
e.
, HRS per week and month/year to month/year or month/year to present).
If your resume does not contain this information, your application may be marked as incomplete and you may not receive consideration for this position.
For additional information see: What to include in your resume.
2.
Other supporting documents: Cover Letter, optional Most recent Performance Appraisal, if applicable Education: You MUST submit a copy of your transcript if you want to substitute your education for experience.
If you claim qualifications based on education, and do not submit a transcript, your education will not be used in making a qualification determination and you may be found "not qualified.
" See: Transcripts and Licenses NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office.
Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you.
You may sanitize these documents to remove another person's personal information before you submit your application.
You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.
S.
Department of Education in order for it to be credited towards qualifications.
Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.
S.
Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
How to Apply To apply for this position, you must complete the online questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 02/23/2024to receive consideration.
To begin, click Apply to access the online application.
You will need to be logged into your USAJOBS account to apply.
If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.
usastaffing.
gov/ViewQuestionnaire/12275748).
Follow the prompts to select your resume and/or other supporting documents to be included with your application package.
You will have the opportunity to upload additional documents to include in your application before it is submitted.
Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position.
Complete the online application, verify the required documentation is included with your application package, and submit the application.
You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date.
Uploaded documents may take up to one hour to clear the virus scan.
Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
To verify the status of your application, log into your USAJOBS account (https://my.
usajobs.
gov/Account/Login), all of your applications will appear on the Welcome screen.
The Application Status will appear along with the date your application was last updated.
For information on what each Application Status means, visit: https://www.
usajobs.
gov/Help/how-to/application/status/.
Agency contact information Army Applicant Help Desk Website https://portal.
chra.
army.
mil/hr_public?id=app_inq Address JT-DHA-DD83BU DHA STAND-ALONE MKT-ROBINS AFB DO NOT CONTACT Robins AFB, GA 31098 US Next steps If you provided an email address, you will receive an email message acknowledging receipt of your application.
Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position.
If you are determined to be ineligible or not qualified, your application will receive no further consideration.
Fair and Transparent The Federal hiring process is set up to be fair and transparent.
Please read the following guidance.
Equal Employment Opportunity (EEO) Policy Reasonable accommodation policy Financial suitability Selective Service New employee probationary period Signature and false statements Privacy Act Social security number request Required Documents The documents you are required to submit vary based on whether or not you are eligible for preference in federal employment.
A complete description of preference categories and the associated required documents is in the Applicant Checklist for Public Announcements.
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply.
If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1.
Your resume: Your resume may be submitted in any format and must support the specialized experience described in this announcement.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations and you may not be considered for this vacancy.
For qualifications determinations your resume must contain hours worked per week and the dates of employment (i.
e.
, HRS per week and month/year to month/year or month/year to present).
If your resume does not contain this information, your application may be marked as incomplete and you may not receive consideration for this position.
For additional information see: What to include in your resume.
2.
Other supporting documents: Cover Letter, optional Most recent Performance Appraisal, if applicable Education: You MUST submit a copy of your transcript if you want to substitute your education for experience.
If you claim qualifications based on education, and do not submit a transcript, your education will not be used in making a qualification determination and you may be found "not qualified.
" See: Transcripts and Licenses NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office.
Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you.
You may sanitize these documents to remove another person's personal information before you submit your application.
You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.
S.
Department of Education in order for it to be credited towards qualifications.
Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.
S.
Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
Help This job is open to The public U.
S.
Citizens, Nationals or those who owe allegiance to the U.
S.
Clarification from the agency See "Who May Apply" in the "Qualification" section for more information on who is eligible to apply for this position.