TRICARE Eligibility Specialist

2 weeks ago


Marquand, Missouri, United States Recruit Monitor Full time
About the Role

As a TRICARE Eligibility Specialist, you will play a critical role in ensuring that patients receive the care they need. Your responsibilities will include responding to inquiries from beneficiaries, providers, and other affiliated representatives or groups regarding TRICARE eligibility, benefit determinations, and claims adjudication questions or problems.

Responsibilities
  • Apply appropriate provisions of TRICARE regulations, interpretations, and procedural directives in making determinations on eligibility and benefits.
  • Analyze claims data to determine specific problem areas and communicate with inquirers to determine appropriate authorization or referral of services.
  • Educate providers on billing requirements of TRICARE to reduce claim problems.
Qualifications
  • U.S. citizenship required due to Department of Defense restrictions.
  • High school diploma or equivalent.
  • 2+ years of experience in customer service.
Benefits
  • A competitive salary of $55,000 per year.
  • The opportunity to work remotely from home.
  • A fun, supportive team that offers great advancement opportunities throughout the organization.


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