About this role
Job SummaryThe incumbent serves as an appeals specialist on matters pertaining to the development, evaluation, and disposition of appealed issues for the Integrated Veteran Care administered programs.
QualificationsTo qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/17/2026. Time-In-Grade Requirement: 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-07 position you must have served 52 weeks at the GS-05. 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. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. Time-In-Grade Requirement: 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-09 position you must have served 52 weeks at the GS-07. 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. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment You may qualify based on your experience and/or education as described below: GS-07 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade in GS-05 the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: . Experience collecting organizing, analyzing and presenting information related to the current and future program workload. Complete assignments with quality and quantity expected with deadlines. Use judgment in locating and selecting the most appropriate guidelines, references and procedures. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 1 full year of graduate level education or Superior Academic Achievement (SAA)* at the baccalaureate level. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. *Superior Academic Achievement at the GS-7 level: SAA at the baccalaureate level in the coursework detailed below is fully qualifying. Applicants who wish to apply under this provision must submit proof from their educational institution that they meet one of the criteria listed below. To qualify for SAA, applicants must have completed all the requirements for a bachelor's degree in a curriculum that is qualifying for the position to be filled and meet one of the following:1. Rank in the upper one-third of your class in the college, university or major subdivision.2. A grade-point average of "B" (a GPA of 2.95 or higher out of a possible 4.0) for all completed undergraduate courses, or those completed in the last two years of undergraduate study.3. A grade point average of "B+" (a GPA of 3.45 or higher out of a possible 4.0) for all courses in your major field of study, or those courses in your major completed in the last two years of undergraduate study.4. Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies. For a list of recognized honor societies please visit http://www.achsnatl.org/quick_link.asp (http://www.achsnatl.org/quick_link.asp); http://www.achsnatl.org/quick_link.asp (http://www.achsnatl.org/quick_link.asp). OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond a bachelor's degree. GS-09 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade in GS-07 the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: . Provides technical advice with research, problem solving analysis and interpretation and evaluation of laws, regulations and polices. Experience performing mathematical/Statistical calculations of difficulty. Maintains and inputs information into databases. Identifies and recommends changes and process improvements. Experience processing health care industry claims. OR, Education: a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, or LL.B. or J.D., if related. OR, GS-09: Combination of Education and Experience (TRANSCRIPTS REQUIRED): successfully completed graduate education and specialized experience directly related to the work of the Legal Administrative Specialist position, may be substituted to meet the experience requirements for GS-09 position. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
Major DutiesArea of Consideration- Eligible applications will be reviewed and referred in the following order: 1. Current VA employees designated as surplus or displaced by the VA - Career Transition Assistance Plan (CTAP) eligible, and current or former federal employee displaced froma position in a federal agency other than the Department of Veterans Affairs (Interagency Career Transition Assistance Plan eligible). 2. Current VA employees of the staff office posting this vacancy - Integrated Veteran Care (current SF-50 must show IVC in box 22 or 135 in box 40) 3. Current employees of the Department of Veterans Health Adminisration 4. Current employees of the Department of Veterans Affairs 5. All other status eligibles Duties include, but are not limited to: Documents all contacts with providers and beneficiaries. Identifies and recommends necessary changes and process improvements. Represents the organization as a member of special work groups and committees. Conducts thorough research, problem-solving analysis, and interpretation and evaluation of laws, regulations, and policies. Makes appeal determinations, supported by facts and a clear understanding of background information. Reviews the claim for error in fact or law and further develops the case based on the submission of additional factual or medical documentation. Provides technical advice both verbally and in writing to staff on a broad range of appeals issues. Provides appeal case discussion in appeal meetings as required. Consults with leads, supervisors, medical staff, and administrative staff regarding clinical appropriateness as well as on regulatory issues and policy interpretations Promotion Potential: The selectee may be promoted to the full performance level 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: Monday - Friday 06:00 AM - 4:30 PM EST Telework: Ad-hoc telework only. A telework arrangement in which an employee is approved by a supervisor to telework on an ad-hoc/case-by-case and non-routine basis, where the hours teleworked are not part of a previously approved, ongoing, or regular telework schedule. Virtual: This is a virtual position this position reports to Denver Federal Center, West 6th Avenue & Kipling Street, Lakewood, CO, 80225 Definition of Virtual Work: Employee works outside of original hiring duty station at a VA-owned or leased space. Position Description/PD#: Legal Administrative Specialist/PD03233A and PD032390A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not AuthorizedRequirementsYou must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.