Veterans, Reservists, Guardsmen and military family members are encouraged to apply!!

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only)

Job Summary

Supervises TRICARE Enrollment operations staff in a high volume production environment processing fee transactions in PGBA TMBS system and Catastrophic Cap Deductible Fee System (CCDFee). Coordinates staff training of new and existing staff on all aspects of Enrollment operations, including customer service. Collaborates with Managers to ensures the Enrollment department meets performance standards and service levels. Coaches and counsels employees on daily processing issues and tracks employee performance levels. Resolves complex enrollment issues escalated by staff. Coordinates work schedules to meet compliance standards

Education & Experience

Required:

• Bachelor's degree in Accounting, Healthcare Administration, or other business-related field or equivalent experience
• US. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Experience in healthcare billing, Accounts Receivable, Auditing, or other Accounting-related discipline
• Thorough knowledge of Accounts Receivable and Accounting principles

Preferred:

• TRICARE Enrollment or fees experience in a production environment
• Payment processing in a healthcare plan
• Knowledge of PGBA TMBS system

Key Responsibilities

• Supervises the Enrollment Fees staff by on PGBA TMBS system training, coaching, counseling, and developing staff.
• Ensures adequate coverage of Enrollment function and adjusts schedules based on workload utilizing Workforce Management software.
• Monitors Beneficiary Enrollment Account Analyst (BEAA) performance levels and real-time reports to ensure contract service standards are met.
• Functions as a Subject Matter Expert on the TRICARE Enrollment Fees processes and workflows.
• Functions as a Subject Matter Expert on the PGBA TMBS Fees processes related to allotment processing, RCC processing and Electronic funds transfers
• Oversees Reconciliations processes across day, week, month, year
• Represents the Enrollment Fees department in cross functional meetings.
• Participates in inter-departmental discussions to educate other departments on the Enrollment Fees business needs and learn the business needs of other departments to promote effective relationships for mutual successes.
• Resolves complex enrollment issues escalated by BEAA staff.

• Monitors system and process discrepancies by researching, reporting on, and developing strategies for process improvement.
• Oversees regular reporting and special projects to ensure completion within required timelines.
• Makes outbound calls to beneficiaries/members to explain complex enrollment fees issues.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.

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.

Creativity / Innovation: Ability to develop unique and novel solutions to problems; View change as necessary.

Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.

Leadership: Successfully manage different styles of employees; Provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Thorough knowledge of TRICARE program, policies, and procedures; Strong understanding of Defense Enrollment Eligibility Reporting System; Knowledge of Enrollment-related software applications including TriMacs, TACC, WRDA, Defense Online Enrollment System (DOES), Catastrophic Cap Deductible Fee System (CCDFee), PCMRS PCM Research, PCM Reassignment (PCMRA) and PGBA TMBS system

Working Conditions

Working Conditions:
Availability to cover any work shift Works within a standard office environment, with minimal travel required

Company Overview

Taking Care of Our Nation's Heroes.

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.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

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:

• Medical, Dental and Vision Coverage


• Generous paid time off


• 401(k) Retirement Savings Plan (with matching)


• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance


• Tuition reimbursement


• Paid volunteer time

*Annual base salary for Colorado, Hawaii and Washington State residents: $77,000 - $85,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.