Beneficiary Service Representative ( R-00063836 )
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 Grafenwoehr, Germany location.
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
• 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.
• 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.
Required Education and Skills:
• One of the following:
Associate's degree (bachelor’s degree preferred) and four years medical experience
Eight years medical experience and no degree
• Cumulative medical 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 other civilian healthcare computer system and in processing medical claims.
• Customer service experience in a public environment.
• Must be eligible for and maintain ADP II/IT2 clearance.
• Fluent in English. Multilingual ability preferred.
• Proficient in written and oral communications.
• Ability to respond tactfully with people.
• Ability to work independently and under general supervision.
• Excellent organizational skills, attention to detail, and time management skills.
• Ability to multitask.
• Knowledge of TRICARE Overseas programs, DEERS, CHCS, and Web General Inquiry of DEERS (GIQD)Pay Range: