Benefits:

Flexible schedule

Job description

Healthcare Benefits Coordinator

QUALIFICATIONS: 4-years’ experience working with TRICARE and civilian health care insurance systems, 2- years’ experience in military human resources, Beneficiary Counseling and Assistance Coordinator training, Proficiency with the use of AHLTA, CHCS, and DEERs systems.

ESSENTIAL KNOWLEDGE: Work requires special knowledge and skill in health care and health insurance areas to include civilian health insurance systems, TRICARE, all DoD health care systems, medical regulations, policies and other directives with regards to all medical issues

SPECIFIC TASKS / RESPONSIBILITIES

Duties include but are not limited to the following:

1. Serves as the subject matter expert on civilian and military health insurance. Interacts with civilian and military insurance programs active duty, reservists, government employees, contractors, and dependents in the geographic area of Military District of Washington. Educates all beneficiaries about TRICARE options available in the National Capital Region.

2. Serves as the civilian health care insurance system subject matter expert. Assist personnel and their dependents with health care coverage, claims, discrepancies and grievances with this health care system.

3. Acts as the Beneficiary Counseling and Assistance Coordinator (BCAC). Advocates for beneficiaries and provides assistance on all TRICARE benefits for unit personnel and their family members. Assists with healthcare provider services. Educates beneficiaries on co-payment, cost shares and deductibles for services rendered. Assist with coordinating care if/when necessary or requested. Facilitates referrals when necessary.

4. Primary POC for all medical IT data entry systems. Facilitates with outside organizations for all staff accounts and access. Coordinates all required training for staff. Enters, manipulates, and or retrieves information and data from the Composite Health Care System (CHCS) Armed Forces Health Longitudinal Technology Application (AHLTA), Ambulatory Data System (ADS), Clinical Information System (CIS), Medical/Personnel and Supply Information System (MEPSIS) as required. Works with civilian systems and monitors medical information to assist with insurance requirements.

5. Program Manager for family care program. Monitors enrollment and eligibility into the program. Maintains all participation documentation. Implemented a tracking database for all participants. Schedules appointments. Works with the template management cell to populate the provider’s schedule. Provides logistic support to the program.Acts as the patient representative for the program. Writes exception to policies for the sponsor and their beneficiaries.

6. Debt Collection Assistance Office (DCAO). Files claims, discrepancies and grievances for unit members and their beneficiaries within the military health care system.

7. Coordinates and manages all inquiries for the TRICARE mail order program (TMOP).

8. Primary interface with Veteran’s Affairs (VA) Health Care system for personnel preparing to retire. Work on special projects designed to develop, implement and evaluate processes related to insurance programs.

9. Conducts monthly information briefing to personnel and dependents on the health care systems, change in civilian health care laws, and new health care plans in which they may participate

10. Conduct analytical studies of program issues and topics. Research background information, the origin of laws, and the intended impact in order to make effective operational program recommendations. Represent the organizations at briefings, hearings at all levels in Government regarding the justification and approval of specific program areas.

11. Establish and maintain relationships with key officials and groups within and outside the organization. Works with Regional Offices, State and local officials, employers and unions, other outside groups and organizations, and contractors to resolve program problems. Evaluate legislation, policies, and program issues to better assess feasibility and consistency of operations and to determine extent and effectiveness of accomplishments.

12. Works with members of the public, state and/or federal governments, and advocacy organization on resolution of individual insurance problems under HIPAA, EMTALA and COBRA for federal governmental sponsors.

13. Oversees internal research and development protocols with regards to equipment, techniques, and procedures.Completes request forms, manually or automated, for individual patient orders for blood work, x-rays, radiation therapy, respiratory and ventilator care, consults and other requests as required.

14. When required coordinates and/or schedules patient appointments with other clinics or specialties. Maintains patient confidentiality at all times. Receives patients and visitors as the initial point of contact in person or telephonically. Records and relays messages and/or redirect calls as necessary. Refers urgent messages and patient results for immediate actions.

15. Reconciles end-of-day processing and reports. As required types routine correspondence, progress reports,medical statements, memorandum and statistical reports using various automation systems and programs.

Job Type: Part-time

Expected hours: 20 per week

Benefits:

Dental insurance

Flexible schedule

Health insurance

Paid time off

Vision insurance

Schedule:

4 hour shift

8 hour shift

No weekends

People with a criminal record are encouraged to apply

Ability to commute/relocate:

Fort Belvoir, VA 22060: Reliably commute or planning to relocate before starting work (Required)

Education:

Associate (Required)

Experience:

TRICARE and civilian health care insurance systems: 4 years (Required)

Security clearance:

Top Secret (Required)

Work Location: In person