Job Description

Position: TRICARE Support Consultant

Location: 100% Remote

Duration: 12 month contract to hire

Overview: Our client is looking for qualified & professional TRICARE Support Consultants to assist in their new DHA TRICARE program. This program provides virtual customer service in support of beneficiaries, family members, military personnel, and medical providers. Using a patient-centric approach, the team will assist callers to navigate and answer the TRICARE program benefit questions, update the beneficiary demographics in the government system, perform enrollments into the TRICARE program, provide provider referrals, assist with prior authorization, assist with claim questions, assist with escalations and directions based off of specific medical diagnoses and questions of beneficiaries, and other calls related to the TRICARE benefits & provider network.

Responsibilities:

· Ensure incoming communications are answered promptly, appropriately, and courteously

· Demonstrate a “can do” and professional attitude when servicing beneficiaries and clients with the objective of exceeding expectations with the service provided

· Provide callers with informed and objective responses to complex or escalated concerns regarding program eligibility requirements, enrollments, and program benefits.

· Provide callers with appropriate & informed responses regarding provide referrals, prior authorization question support, claims questions, general medical question & direction support, and more.

· Deescalate and manage complaints in a professional manner, resolving them wherever possible or escalating them to the appropriate department or line manager

· Accurately perform all data entry functions to reflect and document client activity/transactions and do so in a timely manner

· Ability to multi-task and have multiple screens/programs opened at the same time

· Actively participate in and support departmental and organizational quality initiatives and goals

· Comply with HIPAA (Health Insurance Portability and Accountability) privacy rules

Requirements:

• 3+ plus of contact center experience, preferably in healthcare related field
• Experience with healthcare insurance plans and billing required
• High School Degree required
• Ability to obtain US Security Clearance required
• Ability to speak Spanish, highly preferred
• Reliable high-speed internet

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