TRICARE Beneficiary Services Representative

5 days ago


San Leandro, California, United States Leidos Full time
Job Summary

We are seeking a highly skilled and experienced TRICARE 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 TRICARE beneficiaries, ensuring they receive the best possible care and benefits.

Key Responsibilities
  • Verify benefits eligibility and process enrollments, disenrollments, and portability transfers using the Defense Online Enrollment System (DOES) and other relevant systems.
  • Provide education on TRICARE resources and benefits, enrollment/disenrollment information, and customer service to beneficiaries via phone and in-person.
  • Collect, process, retrieve, and disseminate transfer information to support the TRICARE active-duty and active-duty family member portability/disenrollment process.
  • Conduct briefings for In Processing, Out Processing, Maternity, pre-separation/retirement, and other relevant events.
  • Provide basic claims support, including providing information on the status of claims.
  • Collect and record Other Health Information (OHI) information into applicable systems.
  • Determine the appropriate assistance levels and refer or escalate as needed to address beneficiary questions.
  • Collect and report information on daily activities performed.
  • Assess the appropriate assistance level needed and refer or escalate as needed to address issues.
  • Complete all required HIPAA, Leidos, and other training and refresher courses in a timely manner.
  • Maintain confidentiality and proper handling of Protected Health Information (PHI).
  • Provide remote support to Leidos BSRs at other sites.
  • Adhere to a business casual dress code.
  • Provide shadow support to new BSRs as needed.
Requirements
  • High school diploma or GED.
  • Must be a US Citizen.
  • Be eligible for and maintain ADP IT III clearance/Non-Sensitive Position, Tier 1.
  • 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 MHS Genesis or civilian healthcare computer system and in processing medical claims.
    • Experience in a customer service environment.
Preferred Qualifications
  • SOFA/Command Sponsored as a dependent of an Active-Duty Service Member, DoD employee or US Contractor supporting the DoD.
  • Be fluent in English.
  • Proficient in written and oral communications.
  • Possess effective presentation skills.
  • Computer literate with Internet research experience.
  • Proficient with Microsoft Office 2010 or later applications—Word, Excel, PowerPoint, and Outlook.
  • Ability to respond tactfully with people on the phone and in person.
  • Ability to work independently and under limited supervision.
  • Excellent organizational skills and time management skills.
  • Detail oriented.
  • Ability to multitask.
  • Knowledge of TRICARE Overseas programs, Defense Enrollment Eligibility Reporting System (DEERS), DOES, and MHS Genesis.


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