beneficiary services representative - Carson City, United States - AAI Corporation

Description

Job Description Job Description Salary:
$23.65BENEFICIARY SERVICES REPRESENTATIVE (PEBLO)Nellis AFBAAI is actively looking for a Beneficiary Services Representative (PEBLO). This individual serves as thePhysical Evaluation Board Liaison Officer (PEBLO) for the medical treatment facility (MTF) and itsgeographic area of responsibility. Provides Disability Evaluation System (DES) guidance in accordancewith established DoD guidelines, data collection, medical coordination, Servicemember/commander/stakeholder advising, and procedural work related to Medical Evaluation Board(MEB) processing and Temporary Disability Retired List (TDRL) reevaluations in accordance withapplicable instructions, regulations and directives. Liaison support is provided to active duty and ReserveComponent (RC) members (Air Force Reserve Component (AFRC) and Air National Guard (ANG)) andcommanders on program requirements, military benefits, legal rights, and the appeals process.

Coordinates Aeromedical evacuation or other patient travel requirements, fitness for duty determinations,line of duty (LOD) and other program requirements related to the DES.

Provides Physical EvaluationBoard (PEB) findings to service member and medical staff. Tracks each DES case from referral to finaldisposition. Guides the Service member throughout the DES process.


RESPONSIBILITIES:
Ability to plan, organize, and manage functions and staff within an MTF to meet program objects.

Knowledge of the military healthcare organizational structure, major issues, policies, proceduresand operations related to the management of the healthcare delivery systems.

In-depth knowledge, experience, and training to handle and solve complex cases that arise whenaddressing fitness for duty or physical disability evaluation issues.

Tact, diplomacy, and restraint in counseling and explaining entitlements, benefits, andresponsibilities to all customers.

Effective interpersonal communication skills to effectively accomplish the IDES process Master of oral and written communication and customer service principles, methods, practicesand techniques analytic methods, to include using research tools and statistical analysis and,interpersonal relations practices.

Ability to communicate effectively both orally and in writing to motivate, train, and work effectivelywith a diverse workforce. Must be able to draw realistic conclusions and recommend viablesolutions. Ability to gather data from various sources, analyze data, statistical analysis, prepare statisticalreports and recommendations for improvements. Skill in applying fact finding, analytical, and problem-solving methods and techniques. Knowledge of DES processing regulations, instructions, procedures, and policies to assure timelycase processing. Practical knowledge and understanding of the TRICARE program.


REQUIREMENTS:
Education. Associate Degree in business administration, management or health careorganizations from an accredited college or university. Experience.

Two years experience as a PEBLO within the DoD military health system in the last6 years; or five years experience working in a civilian disability program; or two years experienceas a VA Medical Service Coordinator (MSC).

PERFORMANCE OUTCOMES:

Provides guidance to all ranks of military personnel from all branches of the uniformedservices, retirees, and families of those being processed through the IDES program oftheir rights, benefits, privileges, or obligations.

Coordinates evaluation appointments; schedules follow-up appointments andappropriate referrals related to benefits.

When the Service member is incapacitated or incompetent for pay purposes and unableto manage his/her own legal affairs, the PEBLO provides guidance and assists the legalnext-of-kin on the Service members rights and benefits.

Serves as a liaison between the Service member, their respective commander and amulti-disciplinary team of primary care managers, other appropriate health careprofessionals, medical care case managers, non-medical case managers (e.g.,Recovery Care Coordinators (RCC)), patient administration personnel, the Office of theAirmens Counsel (OAC), the PEB and the Military Department Wounded WarriorProgram liaison or advocate.

Processes Review-in

• Lieu of (RILO) MEB cases for assignment limitation codes asdirected or required by AFPC/DPANM and in accordance with established AF guidance.

Receives and responds to inquiries from beneficiaries, DoD Components, otheragencies, and various interested parties.

Provides guidance on activities with appropriate points of contact throughout the MilitaryHealth System (MHS), the line of the Air Force agencies, (i.e.

Military Personnel Flights,Comptroller, Air Force Personnel Center (AFPC), Transportation, AeromedicalEvacuation) and the Department of Veterans Affairs (i.e. Veterans BenefitsAdministration [VBA] and Veterans Health Administration [VHA]) to best meet themembers needs for information or assistance. Assists in preparing appeals, impartial medical reviews, rebuttals, and coordinates theassignment of Service members legal counsel.

UNIQUE MILITARY HEALTH CARE COMPUTER SYSTEMS/PROCEDURES:
The AFMOA IDES support team will provide ongoing IDES training guidance


PEBLO training will include:

Orientation training, on-the-job training, standardized DES annualrefresher or continuing education and training to ensure PEBLOs remain current in theirunderstanding and application of DES procedures.

Training will be accomplished via computer-based training, monthly DCS teleconference, and ongoing email communications. May berequired to travel to San Antonio for AFMS IDES training workshop at the Governmentsdiscretion every two years. Training will be in accordance with Warrior Care Policy Training Standards and PerformanceObjectives Guidebook. Veteran Tracking Application training will be provided by the Veterans Benefits Administration(VBA/DoD Collaboration Team) via DCS training.


Regulatory Guidance:
DoDM Vol 1, Disability Evaluation System (DES)

Manual:
GeneralInformation and Legacy Disability Evaluation System (LDES) Time Standards, Enclosure 5,DoDM , Vol 2, Disability Evaluation System (DES)

Manual:

Integrated DisabilityEvaluation System (IDES), Enclosure 4 and AFI 41-210, TRICARE Operations and PatientAdministration Functions, Section 4K Medical Evaluation of Service Members (SM) forContinued Military Service.

About AAIAAI is focused on delivering outstanding services to the federal government.

We have extensiveexperience in the fields of cyber security, development, IT infrastructure, supply chain management andother professional services such as system design and continuous improvement.

AAI is a VA CVEcertified Service-Disabled Veteran-Owned Small Business (SDVOSB), SBA certified EconomicallyDisadvantaged Woman Owned Small Business (EDWOSB), and a Woman Owned Small Business(WOSB) with offices in Hampton Roads Virginia, Montgomery, AL, Washington DC and Atlanta.

Fully qualified candidates are welcome to apply directly on our website at:
benefits include:

Paid Federal Holidays Robust Healthcare and Dental Insurance Options 401a plan 401k plan Paid vacation and sick leave Continuing education assistance Short Term / Long Term Disability Life Insurance.

Veterans are encouraged to applyAAI does not discriminate in employment opportunities, terms and conditions of employment, or practiceson the basis of race, age, gender, religious or political beliefs, national origin or heritage, disability, sexualorientation, or any characteristic protected by law.

Pending guidance from the Safer Federal Workforce,employees may in the future be required to provide evidence of COVID-19 vaccination or request andreceive approval for a medical or religious exemption.

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