Medical Call Center Customer Service

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. Apply Job!