TRICARE Enrollment Client Lias

Remote work available in AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only. U.S. citizenship and a favorably adjudicated Department of Defense background investigation are required.

About the Role

Provides support and information to internal Military Veteran Services (MVS) customers related to MTF Enrollment support topics, including eligibility, enrollment, complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments. Helps MVS maintain an effective relationship with MTF staff by assisting with enrollment-related issues, processing enrollments, and capacity requests. Assists with coordination of 100-mile waivers, MTF Enrollment Guidelines, MTF Bulk Enrollment spreadsheets, and MTF exception-to-policy guidelines.

Responsibilities

• Provides expert TRICARE enrollment direction and advice to the MVS team to help MTF POCs maximize TRICARE healthcare delivery.
• Assists with maintenance of MTF Enrollment guidelines and provides timely responses to guideline updates.
• Delivers troubleshooting support for Department of Defense (DoD) systems related to TRICARE enrollment transactions or activities.
• Utilizes advanced research techniques to resolve enrollment issues, including transfer errors, panel issues, and capacity constraints.
• Manages timely completion of issues by tracking, reporting, and resolving them.
• Maintains accuracy and currency of logs for reporting purposes.
• Processes MTF provider panel moves via DEERS within contract compliance time frames.
• Provides insight on preventative tactics to avoid capacity and enrollment issues within the MTF.
• Reviews MTF enrollment guideline update requests and processes documentation for implementation.
• Researches, problem-solves, and processes complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments.
• Communicates with other TriWest staff to resolve complex issues.
• Coordinates with Claims department to reprocess claims for reinstated beneficiaries.
• Responds to incoming calls, emails, correspondence, and faxes to provide timely issue resolution.
• Informs stakeholders of enrollment changes and follows up with reminders as needed.
• Assists in documenting established policies and procedures.
• Defines and implements processes and best practices to ensure quality assurance.
• Prepares and maintains desk procedures for working error and production reports.
• Performs other duties as assigned; regular and reliable attendance is required.

Requirements

• High School diploma or G.E.D.
• U.S. Citizenship.
• Ability to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation.
• TRICARE enrollment experience.
• Proven experience in providing excellent and professional customer service.
• Intermediate level of Microsoft Word, Excel, and PowerPoint.

Preferred Qualifications

• Associate’s degree or equivalent.
• 4 years’ experience in an administrative or medical office.
• 2+ years recent TRICARE enrollment experience.
• Prior experience as a team lead or subject matter expert.

Skills

• Coaching / Training / Mentoring: Actively fosters actions required for desired business outcomes through ongoing constructive feedback.
• Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates.
• Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
• Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach.
• Information Management: Ability to manage large amounts of complex information easily, communicates clearly, and draws sound conclusions.
• Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high-volume, high-stress environment.
• Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
• Team-Building / Team Player: Influences the actions and opinions of others in a positive direction and builds group commitment.
• Technical Skills: Thorough knowledge of TRICARE program, policies, and procedures; proficient with Defense Enrollment Eligibility Reporting System; knowledge of enrollment-related software applications.

Working Conditions

• Availability to cover any work shift.
• Works within a standard office environment, with minimal travel.

Benefits

• Medical, Dental, and Vision Coverage.
• Paid time off.
• 401(k) Retirement Savings Plan (with matching).
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance.
• Tuition reimbursement.
• Paid volunteer time.
• Frequent pay raises, overtime opportunities, recognition, and reward programs.

Pay

This position ranges from around $50,000 to $56,000 per year.