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TRICARE Operations Coordinator Trainee

Requisition Number:  31199
Location: 

Trevose, PA, US

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Overall Purpose of the Role

There are several levels of TRICARE Customer Service Executive which are determined based upon accumulation of knowledge and experience, refinement of skills, the advancement of proficiency and the individual ability to handle increasingly higher degrees of variety, quantity and complexity in daily case load. Responsible for ensuring TRICARE beneficiaries receive the highest quality of healthcare assistance and exceptional, personalized customer service each time they contact the TRICARE Overseas Program by maintaining the highest standards of professionalism, compassion, attention to case management detail and an unwavering dedication to client service.

Key Responsibilities

•    Provide empathetic, quality service to our customers.
•    Update all cases with the appropriate plan of action tasks.
•    Arrive on time for all scheduled shifts, and understand the importance of teamwork in order for all to be successful in daily mission accomplishment.
•    Handle cases and phone calls in an efficient manner. This entails accurately and completely obtaining the required information as defined in TRICARE Overseas Program Standard Operations Procedures.
•    Acts as the first point of contact for new and existing cases for our beneficiaries. 
•    Maintain all cases in accordance with company policies and procedures. 
•    Answer all incoming calls using the prescribed protocols.
•    Promptly and appropriately transfer all medical calls to the TRICARE Coordinating Doctor or TRICARE Coordinating Nurse on duty.
•    Ensure authorizations issued to providers are timely, accurate and appropriate for beneficiary medical needs.
•    Ensure providers are selected based off of inclusion in the TOP Preferred Provider Network.
•    Follow-up with beneficiaries and providers by phone or email whenever necessary to ensure optimal information flow to beneficiaries and providers.
•    Accurately and appropriately initiates Inter Assistance Center notification to facilitate delivery of care.
•    Ensure the TRICARE Medical Team is aware of all medical reports and actions required during the shift. 

 

Key Responsibilities Continued

•    Report to the Assistant Operations Manager / Senior Operations Manager / Coordinating Doctor any cases which may result in a possible complaint.
•    Escalate any complaints received to Assistant Operations Manager/Senior Operations Manager.  
•    Maintains confidentiality of all beneficiary information.  Understand and carry out all policies and procedures pertaining to the duties of a TRICARE Customer Service Executive which govern the protection of confidential patient and beneficiary information as dictated by the United States Government in accordance with the International SOS Assistance, Inc./TRICARE Overseas Program Contract.   
•    Attends and participates in International SOS staff meetings and educational offerings.
•    Maintains a professional environment as evidenced by individual dress, workspace and personal demeanor.
•    Maintain the transmission document in a clear, accurate and concise format with the correct plan of action for hand over to the next shift.  
•    Actively participate in transmission session with input regarding case actions and direction.
•    Use the TRICASE Software Management application for all case management, in/out-bound tasks and actions as per operating procedures.
•    Use the appropriate templates and ensure quality control of all outgoing documentation to beneficiaries, providers or other TRICARE Regional Assistance Centers. 
•    Quickly and accurately action all incoming tasks, faxes, emails and correspondence pertaining to active and/or closed cases in order to maintain flow of case management and resolution.  
•    In the absence of a Manager on duty, ensure the TRICARE Medical team notifies the TOP Regional Medical Director and the on-call Manager of any medical transportation or evacuation. 
•    Maintain open communication lines with CSEs, Assistant Operations Managers, Coordinating Doctors, Coordinating Nurses, GAN Team, Puerto Rico Authorization Team, Clients and other International SOS Assistance Centre staff when dealing with case management. 
•    Adhere to company policies and procedures at all times, regardless of shift being worked. 
•    Assist with the training of new Coordinators by mentoring them during their training program.
•    Comply within established service recovery protocol and complete online CFS form to create feedback record for quality tracking.  
•    Complete other tasks as directed.

Required Work Experience and Qualifications

Required Work Experience (Brief description of the job-related experience needed to perform the job)
•    Customer Service
•    Travel or Study Abroad Experience (Studies, Personal, Volunteer) preferred
•    Volunteer Experience or Internships
•    Previous Professional Work Experience after or during College: Financial, Translation, Education, NGO Experience 
•    Work Experience Preferences: Banking, Teaching (a second language), NGO


Required Qualifications (Brief description of the educational background needed to perform the job)
•    College Graduate Preferred
•    Preferred Degree in: International Business, Language, Liberal Arts, Business Management
•    Typing speed of 40 wpm
•    Proficient in Web Browsing and Microsoft Office (Outlook and Word)

•    Must be a US Citizen and able to obtain interim Tier 3/ Level II IT Security Clearance and maintain full Tier 3/ Level II IT Security Clearance (previously referred to as ADP II Clearance) upon offer acceptance


Required Languages (Brief description of the language skills needed to perform the job)
•    Fluent English
•    Fluent Spanish and/or Portuguese highly desired 


Travel / Rotation Requirements (Brief description of any travel or rotation requirements)
•    Occasional domestic and or international travel may be required
•    Must have or be willing to obtain a Passport 

International SOS Government Services, Inc. require all prospective employees to be fully vaccinated against COVID- 19, where allowed by law.