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Healthcare Support Specialist

1 month ago


Edmond, Oklahoma, United States Triwest Healthcare Full time
Job Summary

This position is responsible for providing support to military treatment facilities (MTFs) and their beneficiaries. The incumbent will work closely with MTF staff to resolve issues related to enrollment, referrals, and authorizations, as well as provide non-clinical support for patient referrals and authorizations.

The ideal candidate will have a strong understanding of the TRICARE program and its policies, as well as excellent communication and problem-solving skills. They will be able to work independently and as part of a team to achieve goals and objectives.

Key Responsibilities:

  • Develop and maintain a clear understanding of TriWest's contracted responsibilities and performance requirements related to support of the MTFs and their beneficiaries.
  • Serve as the designated onsite/on call TriWest point of contact for the MTF staff regarding any of a continuum of issues relating to enrollment, referrals and authorizations, issues with network providers, and any other related matters.
  • Utilizing the TriWest customer relationship management system (CRM), will refer all identified issues to the appropriate TriWest corporate division for follow up and resolution according to MVS operating procedures.
  • Monitor issues referred to them for trends or opportunities to improve TriWest's services and identify root causes of frequently recurring matters referred to them, keeping the Regional Director and associated MVS team members informed in accordance with MVS policies and procedures.

Requirements:

  • High School Diploma or General Education Diploma (GED).
  • US Citizenship.
  • Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation.
  • 2 or more years of experience in working with the TRICARE Program in customer service and administrative support to clinical operations and providers services or equivalent roles.

Preferred Qualifications:

  • Bachelor's Degree in a health-related studies (Health Administration, Health Policy, Public Health, Public Administration or Communications).
  • Experience as a TRICARE Beneficiary Counseling and Assistance Coordinator (BCAC).
  • Experience working in MTF TRICARE business operations.

Benefits:

  • Medical, Dental and Vision Coverage.
  • Generous 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.

Equal Employment Opportunity:

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourage candidates from all backgrounds to apply.