Remote DoD Referral Specialist (TRICARE)

TriWest Healthcare Alliance Corp.; Phoenix (AZ); Remote; USD 47,000 - 49,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan (with 2

Disability insurance

Job summary

TriWest Healthcare Alliance seeks a qualified specialist to perform non-routine specialty processing and ensure accurate authorization data entry from various sources. The role may operate in a virtual environment, with HIPAA confidentiality emphasized.

Required are U.S. citizenship, a DoD background investigation, a high school diploma or GED, and 2+ years in health care operations involving data entry or customer service. Proficiency with Microsoft Office is preferred.

Qualifications

• U.S. Citizenship required for DoD contract.
• High school diploma or GED required.
• 2+ years in health care operations with data entry or customer service.
• Experience with processing specialty referrals and related workflows.
• Proficient with Microsoft Office applications.

Responsibilities

• Process specialty referrals with accuracy in the medical management system.
• Assess authorization/referral requests for proper data entry.
• Ensure compliance with HIPAA and confidentiality guidelines.
• Reference coding systems (ICD-10, CPT, HCPCS) as needed.
• Maintain productivity and meet department performance metrics.
• Coordinate with providers and beneficiaries to clarify documentation.

Skills

Communication

Teamwork

Detail oriented

Adaptability

Education

U.S. Citizenship

High School Diploma or GED

2+ years healthcare data entry or customer service

Experience processing referrals

Tools

Microsoft Office

Job description

TriWest Healthcare Alliance seeks a qualified specialist to perform non-routine specialty processing and ensure accurate authorization data entry from various sources. The role may operate in a virtual environment, with HIPAA confidentiality emphasized.

Required are U.S. citizenship, a DoD background investigation, a high school diploma or GED, and 2+ years in health care operations involving data entry or customer service. Proficiency with Microsoft Office is preferred.