We are seeking a Customer Service Contact Representative to support the Defense Health Agency in Great Lakes, IL.
Successful Candidate will:
● Assist DHA-GL as telephone point of contact on matters related to military Supplemental Health Care Program (SHCP) policies, benefits and entitlements; access to military health care, and the education of service members on care authorization.
● Provide customer service assistance on Line of Duty Pre-authorization, and assistance in the resolution of unpaid claims.
● Provide accurate, technical and timely assistance on requests.
● Fully comply with the Privacy Act and HIPAA, including legal, regulatory, policy and established processes.
● Contact service members and member’s units to validate and retrieve information necessary to complete the process (i.e. identifiable information, and proprietary information)
● Conduct queries in the Defense Enrollment Eligibility Reporting System (DEERS) to establish uniform service personnel’s eligibility.
● Make accurate entry in the Assistance Reporting Tool (ART) on each case.
● Educate service member as well as unit med rep on correct procedure to avoid future problem associated with pre-authorization requests and unpaid claims.
● Fax hard copy documents to the Managed Care Support Contractor’s systems in accordance with established policy once in the morning and once in the afternoon.
● Review all documents related to pre-authorization requests sent to DHA-GL for action (hard copies, ART, electronic systems).
● Develop a working understanding of the Managed Care Support Contractor’s systems in order to discuss claims issues with callers and take appropriate action when necessary.
● Practical knowledge of health care terminology used with a variety of diseases, diagnostic and treatment procedures and practical knowledge of computers and various computer software programs and associated with printer/copier functions
is necessary for eligibility inquiries and for identification of uniformed service personnel.
● Qualified typist and basic computer skills with proficiency in Word Processing Programs (Word, EXCEL, and Outlook) is necessary.
● Knowledge of English grammar and a high degree of skill in oral communication and customer service skills is necessary to conduct professional and tactful interaction with customers, contractors, unit representatives, and healthcare providers.
Send resume and salary requirements to: [ Link removed ] - Click here to apply to Healthcare Customer Service Representative .
Equal Opportunity Employer – Veteran & Disability