TRICARE Enrollment Client Lias

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Provides support and information to internal Military Veteran Services (MVS) customers related to MTF Enrollment support topics, including eligibility, enrollment, complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments. Responsible for helping MVS maintain an effective relationship with MTF staff by assisting with enrollment related issues, processing enrollments, and capacity requests. Also assists with coordination of 100-mile waivers, MTF Enrollment Guidelines, MTF Bulk Enrollment spread sheets, and MTF exception-to-policy guidelines. Education & Experience Required:

• High School diploma or G.E.D
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• TRICARE enrollment experience
• Proven experience in providing excellent and professional customer service
• Intermediate level of Microsoft Word, Excel, and PowerPoint

Preferred

• Associates degree or equivalent
• 4 years’ experience in an administrative or medical office experience
• 2+ years recent TRICARE enrollment experience
• Prior experience as a team lead or subject matter expert

Key Responsibilities

• Provides the MVS team with expert TRICARE enrollment direction and advice so that TriWest can help MTF POCs maximize their TRICARE healthcare delivery to their enrolled population.
• Provides assistance with the maintenance of MTF Enrollment guidelines and provides timely responses to guideline updates.
• Delivers troubleshooting support for Department of Defense (DoD) systems as it relates to TRICARE enrollment transactions or activities.
• Utilizes advanced research techniques for problem-solving enrollment issues to include transfer errors, panel issues, and capacity constraints.
• Manages the timely completion of issues by tracking, reporting, and resolving. Responsible for maintaining the accuracy and currency of the logs for reporting purposes.
• Processes MTF provider panel moves via the DEERS within contract compliance time frames.
• Provides insight on preventative tactics to avoid capacity and enrollment issues within the MTF.
• Reviews MTF enrollment guideline update requests and processes documentation for the implementation of the guideline updates.
• Researches, problem solves, and processes more complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments.
• Communicates with other TriWest staff to resolve complex issues.
• Coordinates with Claims department to reprocess claims for reinstated beneficiaries.
• Responds to incoming calls/e-mails/correspondence/faxes and provides timely resolutions to issues. Informs stakeholders of Enrollment changes and follows and provides reminders as needed.
• Responds to incoming calls/e-mails/correspondence/faxes and provides timely resolutions to issues. Informs stakeholders of Enrollment changes and follows and provides reminders as needed.
• Assists in the documentation of established policies and procedures.
• Defines and implements processes and best practices to ensure quality assurance. Prepares and maintains desk procedures on how to work error and production reports.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies Coaching / Training / Mentoring: Actively fosters actions required for desired business outcomes through ongoing constructive feedback. Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates. Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Information Management: Ability to manage large amounts of complex information easily, communicates clearly, an