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Job Title: Legal Administrative Specialist
Company Name: Veterans Affairs, Veterans Health Administration
Location: Boston, MA
Position Type: Full Time
Post Date: 09/12/2018
Expire Date: 11/11/2018
Job Categories: Agriculture, Forestry, & Fishing, Finance/Economics, Healthcare, Practitioner and Technician, Human Resources, Legal, Research & Development, Medical, Nonprofit and Volunteer Services
Job Description
Legal Administrative Specialist
Major Duties Include (but are not limited to): Provides support to assist Veterans in the reconsideration and appeal process for denied health care claims of medical benefits; Understands and communicates procedures for processing and adjudicating claims for benefits in Non-VA Medical Care programs and new or modified programs administered by Office of Community Care (OCC); Assists the Lead Appeal Specialist in identifying and providing recommendations for process improvements within the employee's area of responsibility; Documents reconsideration and administrative appeal decisions in designated data bases; Consults with Lead Administrative Specialist and designated staff on reconsiderations and appeals on issues such as policy and payment methodologies related to statutory and regulatory interpretations; Reviews claims for error, fact, or law and coordinates with other OCC entities to further develop the case based on the submission of additional factual or medical documentation as well as returning the request back to the submitting entity for local review and response; Coordinates with the Lead Appeal Specialist administrative appeal
determinations when supported by facts and a clear understanding of background information; Formulates a comprehensive approach to obtain information from field sites to analyze data, facts, and references; and Determines the specific information needed to support of the Veterans formal appeal.

Promotion Potential: The selectee may be promoted to the full performance level (GS-9) without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Work Schedule: 8 hour tour, Monday-Friday, between the hours of 7 AM-5 PM, (TBD by Supervisor)
Telework: Not currently available
Virtual: This is not a virtual position.
Position Description/PD#: Legal Administrative Specialist/PD: 35830A (GS-7), 33610A (GS-9)
Relocation/Recruitment Incentives: Not Authorized
Financial Disclosure Report: Not required

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/14/2018.

Time-In-Grade Requirement (GS-7): Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-7 position you must have served 52 weeks at the GS-6. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.
Time-In-Grade Requirement (GS-9): Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-9 position you must have served 52 weeks at the GS-7. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.

You may qualify based on your experience as described below:
Specialized Experience (GS-7): You must have one year of specialized experience equivalent to at least the next lower grade GS-6 in the normal line of progression for the occupation in the organization.
Examples of GS-7 Specialized Experience includes (but are not limited to):
1) Assists with technical advice both verbally and in writing to the Office of Community Care (OCC) staff on a broad range of formal administrative appealed issues after the review of the Lead Appeal Specialist
2) Writes in a clear, concise manner with ability to adequately explain moderately complex matters and describe reasoning and research used in arriving at decisions
3) Utilizes reference sources such as Agency manuals, reference systems, directives, precedent decisions, Code of Federal Regulations, United States Code, and Public Laws sufficient to perform research
4) Provides superior written and verbal communication skills to obtain needed information, responds to inquiries, and clearly states administrative appeal decisions
5) Assists with developing, evaluating, and providing dispositions on appeals related to Office of Community Care (OCC) administered programs
6) Assists with developing accurate, well-documented, complete, and concise appeal determinations that clearly outline further appeal rights to Veterans
7) Assists with basic and moderately complex research, problem-solving analysis, and interpretation and evaluation of laws, regulations, and policies associated with Veteran programs supported by Office of Community Care (OCC).
Examples of GS-9 Specialized Experience includes (but are not limited to):
1) Provides technical advice both verbally and in writing to the Office of Community Care (OCC) staff on a broad range of formal administrative appealed issues after the review of the Lead Appeal Specialist
2) Writes in a clear, concise manner with ability to adequately explain moderately complex matters and describe reasoning and research used in arriving at decisions
3) Utilizes reference sources such as Agency manuals, reference systems, directives, precedent decisions, Code of Federal Regulations, United States Code, and Public Laws sufficient to perform research
4) Provides superior written and verbal communication skills to obtain needed information, responds to inquiries, and clearly states administrative appeal decisions
5) Develops, evaluates, and provides dispositions on appeals related to Office of Community Care (OCC) administered programs
6) Develops accurate, well-documented, complete, and concise appeal determinations that clearly outline further appeal rights to Veterans
7) Performs basic and moderately complex research, problem-solving analysis, and interpretation and evaluation of laws, regulations, and policies associated with Veteran programs supported by Office of Community Care (OCC)

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

  • Communications
  • Interpersonal Effectiveness
  • Standards
  • Technical Documentation


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: The work is primarily sedentary, although some walking, stooping, bending, reaching, and carrying loads weighing up to 10 pounds is required. Data entry using a keyboard is required. Work is performed in an office setting.

None

To apply for this position, you must provide a complete Application Package which includes:

  • Resume
  • SF-50


The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your SF-50's (current VA employees), documentation to support Veterans Preference claims, or CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
  • Cover Letter
  • DD-214
  • OF-306
  • Other
  • Other Veterans Document
  • Resume
  • SF-15
  • SF-50
  • Transcript


Veterans Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled Veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 'Application for 10 Point Veteran Preference' with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans Preference, please visit http://www.fedshirevets.gov/job/vetpref/index.aspx.
Qualifications & Requirements

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/14/2018.

Time-In-Grade Requirement (GS-7): Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-7 position you must have served 52 weeks at the GS-6. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.
Time-In-Grade Requirement (GS-9): Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-9 position you must have served 52 weeks at the GS-7. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.

You may qualify based on your experience as described below:
Specialized Experience (GS-7): You must have one year of specialized experience equivalent to at least the next lower grade GS-6 in the normal line of progression for the occupation in the organization.
Examples of GS-7 Specialized Experience includes (but are not limited to):
1) Assists with technical advice both verbally and in writing to the Office of Community Care (OCC) staff on a broad range of formal administrative appealed issues after the review of the Lead Appeal Specialist
2) Writes in a clear, concise manner with ability to adequately explain moderately complex matters and describe reasoning and research used in arriving at decisions
3) Utilizes reference sources such as Agency manuals, reference systems, directives, precedent decisions, Code of Federal Regulations, United States Code, and Public Laws sufficient to perform research
4) Provides superior written and verbal communication skills to obtain needed information, responds to inquiries, and clearly states administrative appeal decisions
5) Assists with developing, evaluating, and providing dispositions on appeals related to Office of Community Care (OCC) administered programs
6) Assists with developing accurate, well-documented, complete, and concise appeal determinations that clearly outline further appeal rights to Veterans
7) Assists with basic and moderately complex research, problem-solving analysis, and interpretation and evaluation of laws, regulations, and policies associated with Veteran programs supported by Office of Community Care (OCC).
Examples of GS-9 Specialized Experience includes (but are not limited to):
1) Provides technical advice both verbally and in writing to the Office of Community Care (OCC) staff on a broad range of formal administrative appealed issues after the review of the Lead Appeal Specialist
2) Writes in a clear, concise manner with ability to adequately explain moderately complex matters and describe reasoning and research used in arriving at decisions
3) Utilizes reference sources such as Agency manuals, reference systems, directives, precedent decisions, Code of Federal Regulations, United States Code, and Public Laws sufficient to perform research
4) Provides superior written and verbal communication skills to obtain needed information, responds to inquiries, and clearly states administrative appeal decisions
5) Develops, evaluates, and provides dispositions on appeals related to Office of Community Care (OCC) administered programs
6) Develops accurate, well-documented, complete, and concise appeal determinations that clearly outline further appeal rights to Veterans
7) Performs basic and moderately complex research, problem-solving analysis, and interpretation and evaluation of laws, regulations, and policies associated with Veteran programs supported by Office of Community Care (OCC)

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

  • Communications
  • Interpersonal Effectiveness
  • Standards
  • Technical Documentation


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: The work is primarily sedentary, although some walking, stooping, bending, reaching, and carrying loads weighing up to 10 pounds is required. Data entry using a keyboard is required. Work is performed in an office setting.
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Contact Information
Contact Name:
Company Name: Veterans Affairs, Veterans Health Administration
Phone Number:
Fax Number:
Contact Email:Michael.Corbin@va.gov
Website:http://www.ecentralmetrics.com/url/?u=957311022559%2D254&r=http%3A%2F%2Fwww%2Evacareers%2Eva%2Egov%2Fjob%2Dsearch%2Fjob%2Ddetail%2Easp%3Fjob%3D349082
Company Description:

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