Specialized Experience: MUST possess one (1) year of specialized experience equipped with the particular knowledge, skills, and abilities to perform the duties of a Contact Representative. To be creditable,

this experience must have been equivalent to the next lower grade level in Federal service. Specialized experience includes: working experience advising, counseling, and reviewing applications for health benefits, explaining the process of filing a claim for benefits that include eligibility requirements, waivers, forms and documentation needed; developing, examining, adjusting and recommending settlement of claims; receiving and processing requests for authorization of health care services; preparing well defined case notes including updating callers records in a computerized database; possessing interview skills to obtain various kinds of information from caller.

OR

Education Substitution: MUST possess four (4) years of successfully completed education above the high school level in any field for which high school graduation or the equivalent is the normal prerequisite. This education must have been obtained in an accredited business, secretarial or technical school, junior college, college or university. (TRANSCRIPTS REQUIRED)

OR

Combination of Education and Experience: MUST possess the equivalent combinations of successfully completed post-high school education and experience, as described above, and may be used to meet total experience requirements. (TRANSCRIPTS REQUIRED)

You will be rated on the following Knowledge, Skills, Abilities and Other characteristics (KSAOs) as part of the assessment questionnaire for this position:

· Knowledge of the procedures for processing and adjudicating claims for benefits.

· Skill in using, the capabilities, operating characteristics and advance function of a variety of office automation and databases.

· Knowledge of eligibility requirements for various health benefits and payment methodologies.

·Skill in communicating effectively in person with people from a wide variety of backgrounds and levels of understanding.

Physical Requirements: The work is primarily sedentary although some walking, stooping, bending, reaching, and carrying loads weighing up to 20 pounds is required. Use of computer and telephone is extensive and involves use of multiple computer systems simultaneously.

For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. If your resume does not support your questionnaire answers, we will not allow credit for your response(s).

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.


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).  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.

PLEASE NOTE: 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 (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html. All education claimed by applicants will be verified by the appointing agency accordingly. 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.

Veteran's Preference:  When applying for Federal jobs, eligible veterans should claim preference on the Occupational Questionnaire in the section provided and provide a legible copy of DD-214(s) showing all dates of service as well as character of service (honorable, general, etc.). Additionally, veterans with service-connected disability of 10% or more must also submit a copy of their official statement from the Department of Veterans Affairs, or from a branch of the Armed Forces, certifying their service-connected disability and/or their receipt of compensation for service-connected disability.  If the military member is within 120 days of separation and does not yet have a DD214, the member may instead submit any written document from the armed forces that certifies the service member is expected to be discharged or released from active duty service in the armed forces under honorable conditions not later than 120 days after the date the certification is signed.

Veterans with service-connected disability of less than 10%, non service-connected disability, and Purple Heart recipients, as-well-as those claiming derived preference for a spouse, widow or widower, or natural mother, should refer to and submit a completed " SF15, "Application for 10-Point Veteran Preference," (go to http://www.opm.gov/forms/pdf_fill/SF15.pdf) and required documentation with your application materials. For more information on Veterans' Preference, please visit http://www.fedshirevets.gov/job/veterans.aspx.

 

HOW YOU WILL BE EVALUATED:

Applicants will be ranked based on four quality groups, as follows:

  • Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position;
  • Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job;
  • Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
  • Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.

After the vacancy announcement closes, reviewed applications are evaluated against the questionnaire responses and placed in the appropriate quality group.  Qualified veterans will be afforded preference by being placed at the top of the appropriate quality group.  Qualifying veterans with a service-connected disability of 10% or more will be placed at the top of the best qualified group.  The best qualified group is the first to be referred to the hiring facility for further consideration and possible interview.  The remaining groups may be referred based on the number of applicants available.