Remote Call Center Customer Service Representative (Managed Care Provider, Claims, Inbound And Outbound)

**PREFER VETERANS AND MILITARY FAMILIES** **MUST HAVE CALL CENTER EXPERIENCE**

In order to apply you must reside in one of the following states: AZ, ID, NM, OR, TX, UT or WY

Provides outstanding customer service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center. Responds to inbound calls and chat messages regarding authorizations for medical and behavioral health care, provider status and availability, or claims payment and status. Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. May make outbound calls to schedule appointments based on Veteran or VA request. Resolves administrative eligibility discrepancies through account research and review.

Education & Experience

Required:
o High School diploma or GED

o One year experience in a customer service role with performance metrics

o Experience using Microsoft Office products and the Internet

Preferred:
o Healthcare industry experience to include knowledge of health services

o Contact center experience to include call center chat messaging

o Military experience focusing on service delivery

Key Responsibilities

o Manages multiple tasks lists in accordance with directed timelines. Meets call volume, chat volume, schedule adherence, quality, Veteran appointment and other production standards.

o Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, benefit and program questions. In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers. Records preferences, tracks Veteran questions thoroughly in the TriWest’s Customer Relationship Management systems and Portal, as well as VA’s HSRM systems.

o Consistently displays professional and courteous service skills to internal and external customers.

o Accurately resolves VA and provider inquiries with a focus on first call resolution.

o Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI).

o Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information.

o Documents all communications involving Veteran and provider contacts. Uses critical thinking in problem solving and follows established processes to assure quality program compliance.

o Consistently meets department productivity and performance metrics to include regular and consistent attendance.

o Participates in cross training, employee development and flexible assignments to ensure business needs are met.

Taking Care of Our Nation’s Veterans.

It’s Who We Are. It’s What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!

Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• 401(k) Retirement Savings Plan (with matching)
• Paid volunteer time
• Generous paid time off
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Medical, dental and vision coverage

TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.