What are the responsibilities and job description for the Medical Call Center Customer Service position at Triwest Healthcare?

We offer remote work opportunities (AK, AR, AZ, CA,

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

The ACD Specialist lends administrative support to beneficiaries, clinical staff, and providers in support of the Autism Care Demonstration (ACD) The ACD is a benefit program for eligible TRICARE beneficiaries who have an Autism Spectrum Disorder (ASD) diagnosis, and provides a set of services not available under basic TRICARE benefits. As a team member, the ACD Specialist will regularly collaborate and engage with families and other team members to support daily operational tasks and administrative duties assigned. Along with ensuring accuracy and efficiency, this role requires an ability to connect with families in an empathetic manner, attention to detail, and the ability to prioritize and organize the work. ACD Specialists partner with the Autism Services Navigators to identify barriers to care, finding providers, resources, and available services to support families. Duties are primarily performed in a virtual work environment.

Education & Experience

Required :

High School Diploma or G.E.D.

Minimum 2 years' experience in a health care customer service environment

Must be able to receive favorable interim and adjudicated final Department of Defense (DOD) background investigation

U.S. Citizenship

Preferred :

Behavior Technician (BT), Medical Assistant (MA) or Certified Nursing Assistant (CNA)Knowledge of Medical Terminology

Prior experience in a Managed Care Organization (MCO)

Prior experience with TRICARE or VA health plans

Prior experience in a Customer Service call center

Key Responsibilities

Make and receive calls to beneficiaries and their families to meet TRICARE and ACD requirements

Proactively evaluate and process assigned tasks within the medical management system

Schedule and manage meetings in Outlook and system calendaring functions

Manage requests for enrollment in the ACD in collaboration with clinical staff

Collaborate with ECHO team members to facilitate registration into the ECHO

Process requests for beneficiary and / or provider education within established timeframes

Handle incoming and outgoing phone calls, including an inbound phone queue regarding ACD program inquiries in an efficient and professional manner

Respond to daily email messages in an efficient and professional manner

Utilize standard program processes to respond to beneficiary, provider and staff requests

Support the leadership team by coordinating tasks and day-to-day activities, as requested

Efficiently identify and resolve issues or address barriers to daily work

Foster cross-functional communication with other organizational teams / departments

Ability to work independently and collaboratively in a fast-paced environment

Performs other duties as assigned

Regular and reliable attendance is required

Competencies

Commitment to Task : Ability to conform to established policies and procedures; exhibit high motivation.

Communication / People Skills : Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy : Ability to function in a multi-system Microsoft environment using Word, Outlook, TEAMs, TriWest Intranet, the Internet, and department software applications.

Empathy / Customer Service : Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position. Respectful behavior when working with a diverse population and workforce.

Independent Thinking / Self-Initiative : Critical thinker with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without considerable direction and to find necessary resources.

Multi-Tasking / Time Management : Prioritize and manage actions to meet changing deadlines and requirements within a high volume, sometimes demanding environment.

Organizational Skills : Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis : Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.

Team-Building / Team Player : Influence the actions and opinions of others in a positive direction and build group commitment. Respectful behavior in a diverse environment and workforce.

Technical Skills : Working knowledge of the healthcare system and medical terminology. Knowledge of TRICARE programs and benefits, managed care programs or other government healthcare programs.

Working Conditions

Working Conditions :

Extensive computer and telephone work with prolonged sitting

Virtual team members and workflows

Ability to do repetitive work and maintain production standards

Department of Defense security clearance required

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes :

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

Annual base salary for Colorado, Hawaii, Washington D.C. and Washington State residents : $40,000 - $52,000 depending on experience

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 encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

Salary : $40,000 - $52,000

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