Positions in this job family are involved in the coordination of admissions of patients and patient related services. Incumbents serve as advocates between the center/veteran and U.S. Department of Veterans Affairs to maximize services and benefits to the veteran/patient, their families and the agency. The positions in this job family are located at state veterans centers. They provide advocacy services, serve in a liaison role between the patient and federal and state agencies and play a key role in federal fund reimbursement and patient collections.
The functions within this job family vary by level and geographical location, but may include the following:
Coordinates patient admissions and services for veteran clients, to include final determination of qualifications for benefits, patient relations, patient benefit programs and/or transaction records; advises departmental officers and employees on change of status, inter and intradepartmental transfers, readmissions, discharges, maintenance charges, financial information and other patient matters; assesses maintenance charges upon admission based on all sources of income and any non-reimbursed medical expenses.
Completes required actions for reimbursement of funds; coordinates and plans all U.S. Department of Veterans Affairs reports for per diem reimbursement. Prepares and files claims for VA pension and compensation and other entitlements for veterans to include Social Security benefits, Railroad Retirement, Civil Service, Military retirement, etc, ensuring compliance with federal and state laws, rules and regulations.
Counsels with patients and families; interviews veteran applicants, refers applicants to appropriate department heads; conducts background investigations verifying financial status, military retirement and military eligibility; schedules appointments with licensed medical professionals; analyzes financial data to access maintenance charges in accordance with agency policy and advises veteran/family and other departmental officers of final computation; acts as agency liaison with other state agencies, public facilities and other organizations in matters pertaining to veteran clients.
May act on behalf of the institution as Veterans Administration and Social Security appointed payee to include responsibility for maintenance of accounts and records for incompetent veterans; prepares annual accountings as required by federal agencies.
Develops and implements policies and procedures relating to patient services. Gathers information and prepares daily patient census reports for management and other statistical reports as necessary.
KNOWLEDGE, SKILLS, & ABILITIES
Level I: Knowledge of federal and state statutes, rules and regulations pertaining to veterans benefits and programs, Social Security payment; billing of patient care charges; of admitting and benefit counseling and interviewing techniques. Ability is required to communicate effectively, both orally and in writing; to follow written and oral instructions; and to use various software and agency specific programs; and to establish and maintain effective working relationships with others.
Level II: Those identified in Level I plus the ability to organize and conduct several activities simultaneously.
Level III: Those identified in Level II plus ability to maintain a full range of resident accounts; perform highly independent work; and exercise sound judgment in analyzing complex situations and adopting appropriate courses of action.
The Patient Services Coordinator job family has three levels, which are distinguished, based on the complexity of duties assigned and the level of expertise required at the basic, career, and specialist levels.
Level I: This is the basic level where employees build their skills in the processing of patient admissions and services for veteran clients based on federal and state regulations to ensure the appropriate reimbursement of funds and develop skills in counseling patients and families concerning benefits and services and may supervise support personnel.
Level II: This is the career level where incumbents are experienced and perform a full range of duties including, but not limited to, the processing of patient admissions and services for veteran clients, based on federal and state regulations to ensure the appropriate reimbursement of funds and in counseling patients and their families concerning benefits and services.
Level III: This is the specialist level where employees are assigned responsibilities for performing duties with high degree of freedom and independence involving advanced level of technical expertise in providing benefits and services to veterans or other activities involving greater responsibility or accountability than is normally associated with positions at the career level. Responsibility may include supervision of support personnel or may provide guidance and training to others.
Level I: Education and Experience requirements at this level consist of three years of health benefits, insurance claims, admissions, bookkeeping, technical accounting or closely related work; or an equivalent combination of education and experience.
Level II: Education and Experience requirements at this level consist of those identified in Level I plus two additional years of experience in admissions and/or claims and benefits administration in a long term care or medical institution; or an equivalent combination of education and experience.
Level III: Education and Experience requirements at this level consist of those identified in Level II plus two additional years of qualifying experience.
CLASS: N16A; EST: 9/13/2007; REV: 7/2/2012 7:45:00 AM;
CLASS: N16B; EST: 9/13/2007; REV: 7/2/2012 7:45:00 AM;
CLASS: N16C; EST: 9/13/2007; REV: 7/2/2012 7:45:00 AM;