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QUALITY REVIEW SPECIALIST

  • 502133
  • PHOENIX
  • VARIOUS-STATEWIDE
  • DEPT OF VETERAN SERVICES
  • Full-time
  • Closing at: Oct 21 2021 at 17:00 MST

DEPARTMENT OF VETERANS' SERVICES

For Veterans and those who care for them.

QUALITY REVIEW SPECIALIST

DEPARTMENT OF VETERANS' SERVICES

Job Location:

Address:  Arizona (Remote)

Posting Details:

Salary: $39,983 - $47,700 

Grade: 21

Closing Date: October 21, 2021

Job Summary:

This position is responsible for auditing the accuracy and completeness of claims submitted electronically from all agency VSD field offices, and is also responsible for identifying problem areas and assisting with the development of internal processes and training protocols to ensure the quality of our input. This role reviews U.S. Department of Veterans Affairs (VA) Regional Office rating decisions and discusses any suspected inaccuracies with the VA Rating Specialist. The person in this position will advise Veteran Benefits Counselors of necessity to obtain additional evidence to correct discrepancies, initiate formal appellant proceedings and/or otherwise advise claimant to take specific action to obtain proper rating. This position is responsible for representing veterans and/or their dependents in Board of Veterans Appeals Travel Board and teleconference hearings, Decision Review Officer (DRO), Committee on Waivers and Rating Veteran Services Representative (RVSR) hearings. Additionally, this roll will assist with training and mentoring of field office personnel, along with learning, implementing, and monitoring the Arizona Management System (AMS) methods and utilizing AMS concepts and tools for problem solving and continuous work/process improvement and efficiency.

Job Duties:

-Review individual case files following VA rating actions to determine compliance with current laws, rules, and regulations
-Examine medical information including, but not limited to, service medical records, physical examinations, hospital reports, and post-operative reports, and determine degree of residual disability for comparison with VA assignment
-Advise Veteran Benefits Counselors of necessity to obtain additional evidence to correct discrepancies, initiate formal appellant proceedings, and/or otherwise advise the claimant to take specific action to obtain a proper rating, as necessary
-Prepare written arguments on behalf of claimant for review and presentation before the Board of Veterans Appeals
-May represent claimants on personal hearings before the Board of Veterans Appeals Travel Board, teleconference hearings, Committee on Waivers, and Rating Veteran Services Representative (RVSR) hearings
-Present additional evidence of oral argument on claimant's behalf, as allowed
-Audit a variety of claims summitted electronically by agency Veterans services Division offices and employees for adjudication by the Regional Office of the U.S. Department of Veterans Affairs (VA)
-Review individual records for accuracy and completeness and identify problem areas, assist in the development of internal processes and training protocols, and help to establish and maintain standardization
-Maintain records and prepare statistical data and reports
-Review current Court of Veterans Appeals for Veterans Claims' decisions and VA publications and documents to determine their impact of veteran's benefits
-Attend meetings and briefings with various VA Regional Office and Medical Center personnel to keep abreast of policy changes and to offer input on suggestions for improvement of system and delivering benefits
-Attend training sessions offered by the VA
-Attend and present at agency training sessions, assist with ongoing mentoring of agency Veteran Benefits Counselors, and participate in special projects, as assigned

Knowledge, Skills & Abilities (KSAs):

Knowledge of:
-Title 38, U.S.C. and Veterans Administration regulations, policies, procedures, and forms and their application to appeals and complex claims
-Other federal, state, and local benefit programs, as well as military programs
-Community resources for veteran referrals
-Needs and problems of disabled and disadvantaged veterans
-Judicial matters (appeals, hearings) as they relate to veterans' claims administration
-Interviewing/counseling techniques
-Research methods, techniques, and/or sources of information
-Basic training interventions that may be used to develop staff skills and knowledge
-Teaching methods and principles

Skills in:
-Analytics, research, and problem solving
-Communicating information and ideas clearly and concisely, both orally and in writing
-Public speaking/presentations
-Public relations
-Counseling veterans
-Preparing claims and supportive documentation
-Making judgements regarding applicability of regulations
-Computer usage
-Time management and record management
-Preparing reports

Ability to:
-Establish and maintain effective working relationships
-Read, interpret, and apply laws, rules, regulations, policies, and/or procedures

Selective Preference(s):

-Due to the nature of the position, veteran status is preferred

Pre-Employment Requirements:

-Required to become accredited by the U.S. Department of Veteran Affairs and certified proficient by the State of Arizona to assist the state's veteran population. Must maintain accreditation.
-Requires driving in the course of conducting State business
-Requires possession of and ability to retain a current, valid state-issued driver's license

Benefits:

The Arizona Department of Administration offers a comprehensive benefits package to include:
• Sick leave
• Vacation with 10 paid holidays per year
• Health and dental insurance
• Retirement plan
• Life insurance and long-term disability insurance
• Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

Positions in this classification participate in the Arizona State Retirement System (ASRS).
Please note, enrollment eligibility will become effective after 27 weeks of employment.

Contact Us:

If you have any questions please feel free to contact us at recruiting@azdvs.gov and 602.781.7032 for assistance.

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.  
State employees are highly engaged, collaborative and embrace a culture of public service.

Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.