Job Information
TRIWEST HEALTHCARE ALLIANCE CORP Team Lead, Enrollment Specialist in PHOENIX, Arizona
We offer remote work opportunities (AK, AR, AZ, CA, *CO, *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 and 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
Provides training, coaching and direction to Enrollment Specialists. Communicates with regions and other TriWest departments to resolve issues, including eligibility, enrollment, and split enrollment, complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments. Employees are promoted to ES, Team Lead based on a business need of the department.
Education and Experience
Required:
High School diploma or G.E.D. Health plan operations experience such as member enrollment, contact center and billing Prior experience as a team lead Preferred:
Associates degree or equivalent 4 years experience in an administrative or medical office experience 2+ years billing experience
Key Responsibilities
Provides direction to ESs in the processing of enrollment applications and forms. Works with ESs to resolve problems. Forwards enrollment problems to appropriate-level ESs to resolve as needed. Keeps more complex issues to research and solve. Distributes and redistributes work to ESs based on work volume and skill level. Researches and processes more complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments. Problem solves and works on more complex reports. Communicates with other TriWest staff to resolve complex issues. Coordinates with Claims department to reprocess claims for reinstated beneficiaries. Responds to incoming calls/e-mails/correspondence/faxes and provides timely resolutions to issues. Informs stakeholders of Enrollment changes and follows and provides reminders as needed. Tracks and responds to enrollment-related correspondence from beneficiaries.
Assists in the documentation of established policies and procedures. Defines and implements processes and best practices to ensure quality assurance. Prepares and maintains desk procedures on how to work error and production reports. Performs other duties as assigned. Regular and reliable attendance is required.
Competencies
Coaching / Training / Mentoring: Actively fosters actions required for desired business outcomes through ongoing constructive feedback. Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates. Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Information Management: Ability to manage large amounts of complex information easily, communicates clearly, and draws sound conclusions. Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment. 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: Influences he actions and opinions of others in a positive direction and build group commitment. Technical Skills: Thorough knowledge of TRICARE program, policies and procedures; proficient with Defense Enrollment Eligibility Reporting System; knowledge of Enrollment-related software applications.
Working Conditions
Working Conditions:
Availability to cover any work shift Works within a standard office environment, with minimal travel Department of Defense security clearance required We offer remote work opportunities (AK, AR, AZ, CA, *CO, *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 and 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
Provides training, coaching and direction to Enrollment Specialists. Communicates with regions and other TriWest departments to resolve issues, including eligibility, enrollment, and split enrollment, complex fee-related enrollments, status changes, reinstatements, refunds, fees, split-enrollments, and dis-enrollments. Employees are promoted