Enter your Social Security Number in the space indicated. Your Social Security Number is requested under the authority of Executive Order 9397 to uniquely identify your records from those of other applicants who may have the same name. As allowed by law or Presidential directive, your Social Security Number is used to seek information about you from employers, schools, banks and others who may know you. Providing your Social Security Number is voluntary, however we can not process your application without it.
Vacancy Identification Number: 857032
Announcement Number: IHS-13-OK-857032-ESEP/MP
Enter the lowest grade level that you will accept for this position. The lowest grade for this position is 04.
Select/enter at least one geographic location in which you are interested and will accept employment. The location code for this position is:
1. Are you a United States Citizen or National, who is at least 16 years old?A. Yes
Section 231 of the Crime Control Act of 1990, Public Law 101-647, requires that employment applications for individuals seeking employment in a position involved with the provision to children under the age of 18 of “child care services,” as defined in 42 U.S.C. 13041(a)(2), contain a question asking whether the individual has ever been arrested for or charged with a crime involving a child and for the disposition of the arrest or charge. Under 42 U.S.C. 13041(a)(2), the term "child care services" means child protective services (including the investigation of child abuse and neglect reports), social services, health and mental health care, child (day) care, education (whether or not directly involved in teaching), foster care, residential care, recreational or rehabilitative programs, and detention, correctional, or treatment services. Individuals hired for such positions must undergo a criminal history background check.
Section 408 of the Indian Child Protection and Family Violence Prevention Act, Public Law 101-630, contains a related requirement for positions in the Department of Health and Human Services that involve regular contact with or control over Indian children. The agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. The law requires that the agency conduct an investigation of the character of each individual who is being considered for employment in such a position and prescribe in regulations the “minimum standards of character” that must be met in order for an individual to fill such a position. The regulations specify that “[t]he minimum standards of character shall be considered met only after the individual has been the subject of a satisfactory background investigation,” which includes a criminal history background check. 42 C.F.R. § 136.406.
2. Have you ever been arrested for or charged with a crime involving a child?A. Yes
3. Have you ever been found guilty of, or entered a plea of nolo contendere (no contest) or guilty to, any felonious or misdemeanor offense under Federal, State or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; or crimes against persons; or offenses committed against children?A. Yes
If “YES”, provide the date, explanation of the violation, disposition of the arrest or charge, place of occurrence, and the name and address of the police department or court involved.
The following section is used to determine your eligibility for appointment under the Merit Promotion or Excepted Service Examining Plan in the Indian Health Service. Please respond "Yes" or "No" to the following statements. Do not leave any section blank. NOTE: You must submit the required documentation to verify your eligibility as indicated below. Failure to provide the required documents will render you not eligible for consideration. See instructions under the "How to Apply" tab for submitting documentation.
The following section is used to determine your eligibility for appointment under the Merit Promotion or Excepted Service Examining Plan in the Indian Health Service. Please respond "Yes" or "No" to the following statements. Do not leave any section blank.A- Yes.
4. Are you a current, permanent (non-temporary) civilian employee on a competitive service appointment in a Federal agency or a former civilian Federal employee who achieved career status in the competitive service; or an interchange agreement eligible; or a VEOA eligible; or a former civilian Federal employee who served on a career-conditional appointment and was separated less than three years ago without achieving career status in the competitive service? (You must submit supporting documentation).
5. Are you eligible for Indian preference as defined by the Department of the Interior (DOI) and as evidenced by appropriate Bureau of Indian Affairs (BIA) authorized certification? (You must submit a properly completed and signed copy of the Bureau of Indian Affairs (BIA) Form BIA-4432, "Verification of Indian Preference for Employment in the Bureau of Indian Affairs and the Indian Health Service," for employees claiming Indian preference.)
6. Are you an Indian Health Service scholarship recipient who has completed the necessary requirements for an approved health profession degree in accordance with your academic institution and under the Indian Health Care Improvement Act (IHCIA)? (You will receive highest priority placement consideration for available vacancies within the IHS).
7. Have you held a permanent position in the competitive service at the same grade level with the same or higher promotion potential as this position; or be an Interagency Career Transition Program (ICTAP) applicant; or be eligible for a special appointment authority such as a Schedule A for the severely disabled? (You must submit supporting documentation).
8. Are you interested in performing the duties of this position within the United States Public Health Service Commissioned Corps? (You must submit sufficient information to permit this office to determine whether you meet the qualification requirements, including any selective placement factor).
INSTRUCTIONS: The following section is used to determine your Method of Consideration/Referral.
9. Please indicate which of the following plans you want to be considered under: you will only be considered for those that you indicate and are within reach for referral. Do not leave this section blank.
NOTE: You must also submit the required documentation to verify your eligibility as indicated in the vacancy announcement. Failure to provide the required documents will render you not eligible for consideration.
Thank you for your interest in this Medical Support Assistant (OA) - Patient Registration position with the Indian Health Service.
We will evaluate your resume and your responses to this Assessment Questionnaire to determine if you are among the best qualified for this position. Your responses are subject to verification. Please review your responses for accuracy before you submit this questionnaire.
SECTION I. MINIMUM QUALIFICATIONS AND FACTORS.
1. The highest education level I have achieved is:A. GED or high school diploma or less.
2. GS-4: I have at least one year of progressively responsible clerical, or office work.A. Yes
3. GS-4: I have a combination of experience in responsible clerical or office work, and education above high school level that WHEN COMBINED is equal to or greater than 100% percent. To calculate your percentage of education divide your under-graduate hours earned by 60 semester hours (or 90 quarter hours). To calculate your percentage of experience divide your total number of months by 12 (months).A. Yes
4. GS-5: I have at least one year of experience determining eligibility requirements, and obtaining and processing demographic and insurance information for patient registration, alternate resources, contract health services or related purposes.A. Yes
5. GS-5: I have a combination of experience (as described in question 4) and education above high school level that WHEN COMBINED is equal to or greater than 100% percent. To calculate your percentage of education divide your under-graduate hours earned by 120 semester hours (or 180 quarter hours). To calculate your percentage of experience divide your total number of months by 12 (months).A. Yes
6. GS-6: I have at least one year of experience providing receptionist and administrative support in areas such as scheduling, creating official correspondence, timekeeping, and federal travel.A. Yes
7. Can you type at least 40 words per minute based on a 5-minute sample with three or fewer errors?A. Yes
For each statement below, select the appropriate response that best reflects your experience level. Please select only one response. Your resume and/or supporting documentation must support your response.A- Yes
8. I have experience interviewing patients to obtain patient information such as demographic information.
9. I have experience answering routine and recurring inquiries, and directing others to appropriate personnel.
10. I have experience assisting customers with completing forms to ensure accuracy and completeness.
11. I have experience interpreting and applying timekeeping policies and procedures.
12. I have experience in scheduling and coordinating patient appointments using a computerized scheduling program.
13. I have knowledge of Federal travel regulations.
14. I have experience using word processing software to create and edit correspondence.
15. I have experience using spreadsheet and database software to create and edit reports.
16. I have experience reviewing and editing correspondence and forms.
17. I have experience using electronic systems to provide general clerical support.
18. I have experience inputting and updating data in computerized data systems.
19. I have experience using computerized Patient Registration Systems such as Resource and Patient Management System (RPMS).
SECTION II. CERTIFICATION OF INFORMATION ACCURACY
As previously explained, your responses in this Assessment Questionnaire are subject to evaluation and verification. Later steps in the selection process are specifically designed to verify your responses. Deliberate attempts to falsify information will be grounds for disqualifying you or for dismissing you from employment following acceptance. Please take this opportunity to review your responses to ensure their accuracy.
Certification of Information Accuracy
If you fail to answer this question, you will be disqualified from consideration for this position.
20. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled, I may be denied an appointment, or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated. I understand that responding "No" to this item will result in my not being considered for this position.