Tricare Beneficiary Service Representative

hace 1 mes

Segovia, Segovia, España Leidos A tiempo completo

Job Summary: Leidos seeks a highly skilled and detail-oriented individual to support the TRICARE Overseas Program (TOP) under the Defense Health Agency (DHA).


Key Responsibilities:



  • Provide beneficiary education and enrollment support services, including customer support and assistance, beneficiary education, and enrollment support.
  • Verify benefits eligibility and process enrollments, disenrollment, portability transfers, and more using the Defense Online Enrollment System (DOES), Customer Relationship Manager (CRM) systems, etc.
  • Register TRICARE beneficiaries in the Composite Health Care System (CHCS).
  • Resolve enrollment discrepancies between systems and run weekly reports.
  • Perform individual and/or batch Primary Care Manager (PCM) changes, following the Military Treatment Facility (MTF) guidelines.
  • Provide education on TRICARE resources and benefits, enrollment/disenrollment information, and customer service to beneficiaries on the phone and in person.
  • Collect, process, retrieve, and disseminate transfer information to support the TRICARE active-duty portability/disenrollment process.
  • Conduct briefings for In Processing, Out Processing, Maternity, and others.
  • Provide basic claims support, such as providing information on the status of claims.
  • Collect and record Other Health Information (OHI) information into applicable systems.
  • Determine the appropriate assistance levels and when to forward a call or refer as needed to address the beneficiary's question.
  • Collect and report information on daily activities performed.
  • Complete on a timely basis and comply with all required HIPAA, Leidos, and other training and refresher courses.
  • Maintain confidentiality and proper handling of Protected Health Information (PHI).
  • Provide remote support to Leidos BSRs at other sites.
  • Adhere to a business casual dress code.

Requirements:



  • High school diploma or GED.
  • Must be SOFA/Command Sponsored as a dependent of an Active-Duty Service Member or DoD employee.
  • Must be a US Citizen to be considered for this position.
  • Be eligible for and maintain ADP II/IT II clearance.
  • Three years' cumulative experience in the following areas:

    • Experience in U.S. military healthcare delivery system or civilian managed care medical/administrative environment.
    • Experience in a medical or clinical environment.
    • Experience with the CHCS or civilian healthcare computer system and in processing medical claims.
    • Experience in a public environment.


Preferred Qualifications:



  • Associate degree is preferred.
  • Knowledge of TRICARE Overseas programs, Defense Enrollment Eligibility Reporting System (DEERS), DOES, and CHCS.

About Leidos: Leidos is a leading provider of defense, intelligence, and healthcare solutions. We take pride in making a difference for every person we support. Our benefits include competitive PTO packages, 10 paid federal holidays, college tuition and technical certification assistance, on-the-job training support, paid parental leave, paid disability leave, and an incredible internal/external referral bonus program that rewards you for knowing and sharing great talent with us.

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