Customer Service Rep – TRICARE (Remote position)
Job Description
Description & Requirements
Maximus is looking to fill Customer Service Representative I positions supporting our TRICARE program. This program provides virtual customer service in support of beneficiaries, family members, military personnel, and medical providers. Using a patient-centric approach, the team will assist callers to navigate and answer the TRICARE program benefit questions, update… the beneficiary demographics in the government system, perform enrollments into the TRICARE program, change the Primary Care provider for the beneficiary and/or family, assist with claim questions, and other calls related to the TRICARE program. To work on this program, the staff must be able to meet the ADPII Tier 1 government clearance.
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Overview:
Provide assistance in an empathetic and efficient manner for our beneficiaries, end users, and clients follow the program guidelines. Maintain Maximus Federal’s highest standards of customer service and excellence and ensure optimal quality case coordination and service delivery. TRICARE Support Consultants (TSC) will not only address the current issue but also anticipate future needs, fostering a consultative relationship. Staff can move up through the TSC levels with experience, from Tier 1 to Tier 3 (Universal).
Essential Duties and Responsibilities:
– Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters).
– Calls are basic and routine.
– Uses computerized system for tracking, information gathering, and/or troubleshooting.
– Provides feedback when needed, provide input on call trends, processes, procedures, and training.
– May respond to customer inquiries by referring them to published materials, secondary sources, or more senior staff.
Education:
– High school diploma or GED required. Bachelor’s Degree or equivalent government or private-sector work experience preferred.
– Proficient with computer including Microsoft Office Suite, internet and multi-tasking between multiple screens and programs
– Ability to pass a skills assessment
MinimumRequirements:
– Ability to obtain US Security Clearance
– Must be a US Citizen
Essential Duties and Responsibilities:
– Ensure incoming communications are answered promptly, appropriately, and courteously
– Demonstrate a “can do” and professional attitude when servicing beneficiaries and clients with the objective of exceeding expectations with the customer service provided
– Provide callers with informed and objective responses to complex or escalated concerns regarding program eligibility requirements, enrollments, and program benefits.
– Retrieve, research, and analyze data from multiple databases to answer client concerns.
– De Escalate and manage complaints in a professional manner, resolving them wherever possible or escalating them to the appropriate department or line manager
– Accurately perform all data entry functions to reflect and document client activity/transactions and do so in a timely manner
– Ability to multi-task and have multiple screens/programs opened at the same time
– Meet performance requirements and maintain knowledge of project policies and procedures
– Actively participate in and support departmental and organizational quality initiatives and goals
– Work in a systematic, methodical, and orderly way to maintain quality work and high productivity
– Maintain effective interdepartmental relationships and interaction with peers to create a cohesive and productive environment
– Make recommendations for changes to current policies or need for new policy to your supervisor in the spirit of process improvements
– Complete any other reasonable duties as requested by the manager
– Comply with HIPAA (Health Insurance Portability and Accountability) privacy rules
Experience:
– Minimum of 1+ years of contact center experience, preferably in healthcare related environment
– Minimum 3+ years of experience in delivering excellent customer service in a high-paced environment
– Experience with healthcare insurance plans and billing
– Experience with military health program
– Experience of healthcare terms
– Experience working remotely as part of a team including using Microsoft Office Suite, Teams, Zoom, SharePoint, Chat, and other digital tools
Skills:
– Ability to speak Spanish, highly desirable
– Excellent written and oral communication skills
– Strong interpersonal skills with the ability to build relationships
– Proactive, self-starter with the ability to work well in a team environment
– Detail-oriented with good organizational skills and capable of effectively
prioritizing and multitasking
Remote Work Requirements:
– HIPPA compliant workspace-Private and Secure workspace away from others, noise, and distractions
– Reliable high-speed internet-Ethernet/hard wired Connection (no WiFi or Hotspots)
– Internet download speed of 25mbps and 5mbps (10 preferred) upload or higher required (you can test this by going to www.speedtest.net)
Minimum Requirements
– High School diploma or equivalent with 6 months of customer service experience.
– Must be able to speak and read English clearly, professionally and fluently.
