Contact Representative

Military Treatment Facilities under DHA; Norfolk (VA); On-site; USD 60,000 - 86,000; Full time

Job summary

The Defense Health Agency seeks a Contact Representative for TRICARE benefits, acting as a beneficiary counselor and advisor for Military Health System members. The role also includes duties as a Debt Collection Assistance Officer to support program rights and enrollment processing.

As part of the DHA team, you will gather and input data, respond to beneficiary inquiries, and help coordinate referrals and case processing across the TRICARE network.

Qualifications

• Specialized experience at GS-06 level: data entry, monitor referrals, enrollment processing
• Specialized experience at GS-07 level: assist/referral coordination, beneficiary counseling
• Specialized experience at GS-08 level: resolve claim discrepancies, provide regulatory guidance on rights and benefits

Responsibilities

• Serve as a Contact Representative, beneficiary advocate and advisor for TRICARE benefits
• Counsel beneficiaries on eligibility, enrollment and claims
• Maintain and input data, track referrals, and support case processing

Job description

About the Position:

Serves as a Contact Representative, a beneficiary advocate and advisor providing service and assistance to Military Health System beneficiaries in understanding and obtaining benefits via the TRICARE program. Serves as a Beneficiary Counseling and Assistance Coordinator and Debt Collection Assistance Officer.

Who May Apply:

• Current Civilian Employees of the Defense Health Agency (DHA)
• Current Permanent Department of Defense (DoD) Civilian Employee
• Domestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel Workforce
• Interagency Career Transition Assistance Plan
• Land Management Workforce Flexibility Act
• Military Spouses, under Executive Order (E.O.) 13473
• Priority Placement Program, DoD Military Reserve (MR) and National Guard (NG) Technician Eligible
• Priority Placement Program, DoD Military Spouse Preference (MSP) Eligible
• Priority Placement Program, DoD MR and NG Preference Eligible Tech Receiving Disability Retirement
• Priority Placement Program, DoD Retained Grade Preference Eligible
• Veterans Employment Opportunity Act (VEOA) of 1998

In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

Specialized Experience (GS-06):

One year of specialized experience which includes any two or more of the following: gathering and inputting data into a computer system, monitor referral data using automated and/or non-automated methods from external and internal reports, receive incoming calls, walk-in visits from patients, and enrollment processing. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS- 05).

Specialized Experience (GS-07):

One year of specialized experience which includes any two or more of the following; assisting and providing information in the referral and authorization process with specialty care referral review, coordination, tracking, and beneficiary counseling; answer routine questions from beneficiaries related to medical insurance claim submissions, collections, and case resolution processes. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06).

Specialized Experience for (GS-08):

One year of specialized experience which includes any two or more of the following; assisting beneficiaries by resolving or correcting discrepancies of existing medical claims, providing regulatory healthcare guidance to the patient population on their rights, benefits, privileges, access to care and available eligibilities, counseling beneficiaries on a broad range of available health benefit programs. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-07).

Time in Grade Requirement for GS-06:

Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-05).

Time in Grade Requirement for GS-07:

Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06).

Time in Grade Requirement for GS-08:

Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-07).