Customer Serv Rep - Ah
TriWest Healthcare Alliance (Colorado Springs, Colorado)

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COMPANY OVERVIEW TriWest Healthcare Alliance, headquartered in Phoenix, Arizona, manages and administers quality healthcare services for our nation's active and retired uniformed military service members and their families, through a contract with the Department of Defense. These individuals are eligible for the DoD's regionally managed health care program for the military, called TRICARE. TriWest manages and administers TRICARE throughout the 21-state TRICARE West Region. In addition to supporting military families through the TRICARE program, TriWest has developed relationships with organizations such as the USO, Fisher House, the Women in Military Service for America Memorial Foundation and other military relief and support associations to strengthen America's military community locally and nationally. TriWest provides state-of-the-art facilities, a smoke/tobacco-free, drug-free, business casual working environment, and offers a competitive compensation package including excellent benefits. For more information about TriWest, please explore our website at www.triwest.com. DOD STATEMENT You are applying for a position that involves working on electronic systems that have access to Department of Defense ('DoD') systems. Therefore, you must undergo a DoD background investigation. This requires you to submit an application describing the previous 7 years of your life and to provide proof of U.S. citizenship in the form of a certified birth certificate, certificate of naturalization, current passport, form FS-240 or form DS-1350. This process takes several months to complete. During this time, the DoD will grant interim access to U.S. citizens allowing them to work for TriWest until their background investigation is completed. However, the DoD will not authorize interim access for non-U.S. citizens. If you are unable to obtain interim access or pass the background investigation, you are not qualified for this position and TriWest will withdraw any offer of employment or terminate your employment immediately. JOB SUMMARY/DESCRIPTION Job Summary: Responds to telephone and web-mail inquiries from beneficiaries and providers regarding all aspects of the TRICARE program. This is a beginning level Customer Service Representative working under the direct supervision of the Customer Service Representative Supervisor. Employees are promoted to CSR I after completing the initial requirements of the Basic Skills Set course. Key Responsibility Areas: o Responds to telephone and web-mail inquiries from beneficiaries and providers regarding all aspects of the TRICARE program. Information and assistance includes enrollment, eligibility, benefits, referrals, authorizations, claims/collections, and the location and use of network and certified providers o Documents all communications involving beneficiary and provider contacts o Coordinates complete resolution of service issues by interfacing with other departments, including Enrollment, Claims, Health Care Services o Learn required measures to protect the privacy of health information of TriWest beneficiaries when using or disclosing Protected Health Information (PHI). PHI is any information about health status, health care services, or payments for health care that are linked to an individual o Develops knowledge of various software applications in use at TriWest, including procedures and processes of the TRICARE program o Develop an understanding of the grievances and appeals process available to dissatisfied beneficiaries and providers o Performs other duties as assigned, in compliance with TRICARE policies and contractual requirements Working Conditions: o Ability to cover any work shift 6:00 a.m. - 6:00 p.m. M-F , with no travel o Works within a standard office environment o Extensive computer work with prolonged sitting and wearing of headset for 7.5 hours QUALIFICATIONS Education & Experience: Required: o High School diploma or G.E.D. o Successful completion of TriWest Customer Service Representative training course, general skill test, and proficiency demonstration Preferred: o 1+ years college or equivalent o 1+ years experience in an administrative or medical office environment o 1+ years experience working in an inbound call center Knowledge & Skills: Technical Skills: Proficient data entry skills; Ability to achieve a Meets Expectations rating or higher on monthly production bonus scorecard Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position Information Management: Ability to manage large amounts of complex information easily, communicate it clearly, and draw sound conclusions Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources BENEFITS TriWest offers a comprehensive and progressive benefits package that includes: o Medical, dental and vision coverage o Generous paid time off o 401(k) Retirement Savings Plan (with matching) o Short-term and long-term disability, basic life, and accidental death and dismemberment insurance o Voluntary plans such as pet insurance, long-term care and 529 College Savings Plans o Reimbursement for various wellness initiatives o Tuition reimbursement EQUAL EMPLOYMENT OPPORTUNITY TriWest Healthcare Alliance is an equal employment opportunity employer. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.