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TRICARE Beneficiary Services Representative

2 months ago

Northampton, Northamptonshire, United Kingdom Leidos Full time
Job Summary

We are seeking a highly skilled Beneficiary Services Representative to join our team at Leidos. As a key member of our team, you will provide exceptional customer service and support to beneficiaries of the TRICARE Overseas Program.

Key Responsibilities
  • Beneficiary Education and Enrollment
    • Verify benefits eligibility and process enrollments, disenrollments, portability transfers, and more using the Defense Online Enrollment System, Customer Relationship Manager systems, etc.
    • Register beneficiaries in the Composite Health Care System
  • Discrepancy Resolution
    • Resolve enrollment discrepancies between systems, and run weekly reports
  • Primary Care Manager Changes
    • Perform Primary Care Manager changes, following the Military Treatment Facility guidelines
  • Customer Service
    • Provide education on resources and benefits, enrollment/disenrollment information, and customer service to beneficiaries on the phone and in person
  • Transfer Information
    • Collect, process, retrieve, and disseminate transfer information for active-duty portability/disenrollment processes
  • Briefings and Claims Assistance
    • Conduct briefings for In Processing, Out Processing, Maternity, and others
    • Provide basic claims assistance such as providing information on the status of claims
  • Health Information Management
    • Collect and record other Health Information into applicable systems
  • Assessment and Referral
    • Assess the appropriate assistance levels and when forward a call or refer as needed to address the beneficiary's question
  • Reporting and Compliance
    • Collect and report information on daily activities performed
    • Complete on a timely basis and comply with HIPAA regulations, Leidos, and other training and refresher courses
  • Confidentiality and Security
    • Maintain confidentiality and proper handling of Protected Health Information
  • Adherence to Company Policies
    • Adhere to a business casual dress code
Requirements
  • Education
    • High school diploma or GED
  • Citizenship
    • Must be a US Citizen to be considered for this position
  • Clearance
    • Be eligible for and maintain ADP II/IT II clearance
  • Experience
    • 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
    • Experience in a public environment
Preferred Qualifications
  • Language
    • Be fluent in English
  • Communication Skills
    • Proficient in written and oral communications
  • Presentation Skills
    • Possess effective presentation skills
  • Computer Skills
    • Computer literate with Internet research experience
    • Proficient with Microsoft Office 2010 or later applications—Word, Excel, PowerPoint, and Outlook
  • Interpersonal Skills
    • Ability to reply tactfully with people on the phone and in person
  • Organizational Skills
    • Ability to work independently and under general supervision
    • Excellent organizational skills and time management skills
  • Detail-Oriented
    • Detail oriented
  • Multitasking
    • Ability to multitask
  • Education
    • Associate degree is preferred
  • Knowledge
    • Knowledge of Defense Enrollment Eligibility Reporting System and CHCS.