Contact Representative

Contact Representative

Summary

As a Contact Representative at the GS-0962-6, you will be part of Healthcare and Insurance, Office of Personnel Management. If selected, you will be responsible for providing a broad range of assistance to meet the diverse needs of the Federal Employees Insurance Operations (FEIO) customers.

This job is open to

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Career transition (CTAP, ICTAP, RPL)

Federal employees who meet the definition of a "surplus" or "displaced" employee.

Duties

• Answers incoming telephone calls, correspondence, and provides direct responses to specific inquiries regarding FEHB Programs.
• These responsibilities require knowledge of the laws and regulations governing the Programs, specific plan provisions, and current information related to enrollment and to insurance administrative systems.
• Assists in Group administrative tasks, such as filing, recordkeeping, and assembling information packets and briefing materials.
• Tracks and processes workloads, such as disputed claims within the Groups that administer FEHB Program contracts.
• Performs automation support activities, and public contact activities throughout the FEIO in Groups, including those that operate open seasons and support the contracting Groups, and those that administer Individual Benefits and Life Insurance contracts.
• Responds in a personable and professional manner to customer inquiries received over the telephone.
• Helps inquirers understand FEHB processes and procedures and the respective Program features.
• Responds verbally over the telephone, and to written correspondence via e-mail and regular mail. Questions range from routine to complex in nature and pertain to a variety of Program issues, especially enrollment, premium, coverage, and current Program policies. Questions and correspondence may also relate to disputed claims processing, status and routine submissions.
• Helps customers with routine requests for assistance requiring immediate action, such as getting an enrollee in touch with the agency officials who can process transactions on behalf of the customer.
• Keeps other office employees and leadership aware of current troublesome situations with broad patterns of repetition or sensitivity.
• Uses and participates in the re-engineering and improvement of office documentation and tracking systems.
• Monitors and updates status information with respect to, e.g., case files, and correspondence related to such workloads.
• Associates supporting documentation and correspondence (including priority correspondence) with existing cases and identifies and sorts out duplicate materials.
• Enters appropriate status information into control / tracking systems.
• Assists with workload distribution and assignment by classifying, assigning tracking numbers, and giving claim case files to Examiners.
• Assures completeness of information received before assigning case to Claims Examiner, obtains reconsideration files and other information from health plans, follows up with health plans that do not timely supply requested information.
• Assists in developing and maintaining databases, web pages, and other computer-related resources.
• Reviews outgoing packages to assure that they are assembled properly and routed appropriately to obtain all necessary clearances.

RequirementsConditions of Employment

• Must be a U.S. Citizen or National
• Males born after 12-31-59 must be registered or exempt from Selective Service (see https://www.sss.gov/Home/Registration)
• Suitable for Federal employment, determined by a background investigation
• May be required to successfully complete a probationary period
• Complete the initial online assessment and USAHire Assessment, if required
• This position is eligible for inclusion in the bargaining unit. The union that represents employees in this position is the American Federation of Government Employees (AFGE) Local 32.

Qualifications

For the GS 6: You must have at least one year (52 weeks) of specialized experience which is equivalent in difficulty and complexity to the GS-5 level in the Federal Service that demonstrates all of the following:
1) Assists in performing administrative tasks which may include entering information into a tracking system, managing records, and/or interacting with customers;
2) Reviewing information in a customer's healthcare record in order to resolve an issue;
3) Responding to customer requests through verbal and written communication;AND
4) Working with team members to resolve complex or highly sensitive customer issue.

You must meet all qualification and eligibility requirements by the closing date of this announcement.

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.

Education

This job does not have an education qualification requirement.

Additional information

Incentive payments may be considered.

This job opportunity announcement may be used to fill additional similar vacancies across OPM.

Career Transition Assistance Programs: These programs apply to employees who have been involuntarily separated from a Federal service position within the competitive service or Federal service employees whose positions have been deemed surplus or no longer needed. To receive selection priority for this position, you must: 1) meet CTAP or ICTAP eligibility criteria; 2) be rated well-qualified for the position and 3) submit the appropriate documentation to support your CTAP or ICTAP eligibility. For more information visit: http://www.opm.gov/rif/employee_guides/career_transition.asp.

Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended and Americans with Disabilities Act 1990 as amended, that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a reasonable accommodation in your online application. Requests for Reasonable Accommodations for the USA Hire Competency Based Assessments and appropriate supporting documentation for Reasonable Accommodation must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for Reasonable Accommodations are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments, if you received the link after the close of the announcement. To determine if you need a Reasonable Accommodation, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire