TRICARE Beneficiary Service Representative

Description

Job Description:

Military and Veteran’s Health Solutions Group TRICARE Overseas Program (TOP) program provides enrollment, marketing, and education services to military communities around the world. The TOP enrollment program includes the Pacific, Eurasia-Africa, and Latin America and Canada (TLAC) regions.

Leidos is currently seeking a qualified Global TRICARE Service Center (GTSC) Beneficiary Service Representative for our Sembach, Germany location.

Position Overview:

Under minimal supervision, serve as TRICARE liaison for TRICARE Overseas Prime (TOP) beneficiary population. Independently perform a variety of tasks concerned with customer service, administrative tasks, enrollment and disenrollment, portability, TRICARE education, and issues tracking. Maintain confidentiality and ensure that information meets the standards and requirement established by the Defense Health Agency (DHA) and partnering professional organizations (i.e., the Prime Contractor, International SOS (ISOS) and Wisconsin Physicians Service (WPS).

Reports to the Deputy Program Manager and ISOS Country Lead

Travel 10-25% to other local sites within the region.

Responsibilities:

• Travel to local sites within the region providing coverage as needed, 10-25% of the time. Local sites may include but is not limited to Ramstein, Kleber, Landstuhl, and Baumholder

• Process registration of TRICARE beneficiaries in the Composite Health Care System (CHCS).

• Process enrollments, disenrollments, and portability transfers using the Defense Online Enrollment System (DOES).

• Process and correct enrollment discrepancies between CHCS and DOES.

• Assign primary care managers to TRICARE beneficiaries.

• Verify eligibility information for remote beneficiaries.

• Provide education on TRICARE plans, programs, systems/tools, and enrollment information to beneficiaries on the phone and in person.

• Assist walk-in beneficiaries with enrollments and inquiries.

• Handle faxed enrollment forms.

• Research and interpret benefits, policies, and procedures to military staff, remote site points of contact, and other resources.

• Maintain files/forms via electronic systems/paper files and data integrity.

• Provide customer support to the Military Treatment Facility Commander and/or the TRICARE Area Office staff as directed by the Deputy Program Manager, ISOS country Lead or Program Manager.

• Provide basic claims support such as portal education, claims submission education, and providing status of claims.

• Serve as liaison between the TRICARE Regional offices and TRICARE beneficiaries for transitional/portability assistance.

• Collect, process, retrieve, and disseminate transfer information to support the TRICARE active duty portability process.

• Conduct off-site briefings such as enrollment briefings, fairs, or other functions when directed by the Deputy Program Manager, ISOS country Lead or Program Manager.

• Determine the appropriate assistance levels and when call forwarding or other referrals are needed to address the beneficiary’s question.

• Complete all responsibilities and duties in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines to include proper handling of Protected Health Information.

• Complete on a timely basis and comply with and all required HIPAA, Leidos, and other training and refresher courses.

• Maintain required system accounts.

• Be eligible for and maintain ADP II/IT II clearance.

• Adhere to the dress code at the TSC.

Primary Responsibilities

Required Education and Skills:

• High school diploma or GED. Associate’s degree preferred.

• Three years’ cumulative experience in the following areas:

 Experience in U.S. military healthcare delivery system or civilian managed care medical/administrative environment.

 Experience in a medical or clinical environment.

 Experience with the CHCS or civilian healthcare computer system and in processing medical claims.

• Customer service experience in a public environment.

Key Competencies:

• Fluent in English.

• Proficient in written and oral communications.

• Effective presentation skills.

• Computer literate with Internet research experience.

• Proficient with Microsoft Office 2007 or later applications—Word, Excel, PowerPoint, and Outlook.

• Ability to respond tactfully with people on the phone and in person.

• Ability to work independently and under general supervision.

• Excellent organizational skills and time management skills.

• Detail oriented.

• Ability to multitask.

• Knowledge of TRICARE Overseas programs, Defense Enrollment Eligibility Reporting System (DEERS), DOES, and CHCS.

Pay Range: