Program Support Assistant
The Cincinnati VA Medical Center (CVAMC) is a two-division campus located in Cincinnati, OH and Fort Thomas, KY serving 15 counties in Southwest OH, Northern Kentucky, and Southeast Indiana with 6 Community Based Outpatient Clinics located in Bellevue, KY; Florence, KY; Lawrenceburg, IN; Hamilton, OH; Clermont County, OH, and Georgetown, OH. The CVAMC also supports two off main campus locations in the Cincinnati area via an Eye Center and Mental Health Outreach Community Division.
Major Duties:
- Creates authorization for payment of community care in the Fee Basis Claims System (FBCS) or alternative software system with pertinent information including the community provider's name, address, category of care, obligation number, number of visits, purpose of visit, and length of authorization.
- Provides administrative support to ensure all pertinent information is transmitted to appropriate parties for community care that is authorized under any other funding source.
- Electronically uploads all pertinent clinical and administrative data to a third-party administrator as appropriate.
- Serves as an administrative point of contact in the request, coordination, and authorization for community care consults.
- Works collaboratively with VACC RN Patient Care Coordinators, VACC Program Analysts, other VA staff and Community Care providers.
- Receives, handles, and transfer calls appropriately with regard to telephone inquiries from numerous sources including patients, other VA staff, and community providers concerning items including but not limited to: authorization terms, appointment status and billing/claims status.
- Prepares correspondence to be sent to community providers that includes details about the terms of the authorization, the appointment date and time, and all pertinent clinical data as instructed by the RN Patient Care Coordinator. Prepares correspondence to be sent to patients that includes details about the terms of the authorization, including the provider's name and location and appointment date and time.
- Performs weekly validations of authorizations and input, process, edit and or investigate suspended claims in FBCS to ensure accuracy of authorization entry.
- Inputs or edits community provider information into VISTA as requested by Pharmacy Service.
- Other related duties, as assigned
Work Schedule: Monday - Friday (8am - 4:30pm) or (7:30am - 4pm)
Position Description/PD#: Program Support Assistant/ PD91909A
Relocation/Recruitment Incentives: Not Authorized
Critical Skills Incentive (CSI): Not Authorized
Physical Demands: Regular and recurring work generally involves sitting at a desk and sitting in conferences and meetings except for occasional visits to facility work sites. Occasional use of automobiles and public conveyance may be required. No special physical exertion is required. Incumbent may be required to travel between main campus, Fort Thomas Division, and six Community Based Outpatient Clinics (CBOC).
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