Medical Benefits Liaison
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The Medical Benefits Liaison provides support to the 82nd Medical Group at Sheppard Air Force base. This position assists the Uniform Business Office by acting as the benefits advisor/coordinator to an international trainee population. The Medical Benefits Clerk is responsible for coordinating the referrals with the specialty care offices, facilitating the recapture of Medical Treatment Facility (MTF) direct care capabilities, and tracking the enrollment of the 82d Medical Group Foreign population. This position accurately advises customers on health benefits and initiates and processes claims for first- or third-party payers on behalf of foreign military personnel and beneficiaries treated in MTFs.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Essential duties and responsibilities include the following. Other duties may be assigned.
Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge / quality of work, supporting financial goals of the company, initiative / motivation, cooperation / relationships, problem analysis / discretion, accomplishing goals through organization, positive oral / written communication skills, leadership abilities, commitment to Affirmative Action, reliability / dependability, flexibility and ownership / accountability of actions taken.
Assists with educating beneficiaries and MTF staff about the various billing and collection programs and processes to include required forms, Third Party Collections - Record of Other Health Insurance, and the required completion of an Injury Log.
Assists with procedures and processes for Third Party Collections, Medical Service Accounts and Medical Affirmative Claims following the Military Treatment Facility (MTF) Uniformed Business Office (UBO) Manual.
Serves as the point of contact on matters relating to health benefits programs available to eligible foreign military and trainee population beneficiaries. Provides specific advice on all eligibility requirements, exclusions of certain diseases or conditions, coverage of medical conditions, out of pocket cost, coordination of benefits, and any applicable program rules.
Provides advisory services on benefits offered through the TRICARE program for foreign military members assigned to Sheppard AFB.
Provides counseling and guidance concerning TRICARE rights, benefits, and obligations. Interviews personnel by telephone and in person to obtain information concerning military status of the sponsor, the type of medical care obtained, possible coverage under health insurance other than Uniformed Services Health Benefits Program, and other factors which may be involved in accessing care such as changes in status of beneficiaries, necessity for pre-authorization, etc. for foreign patients as well as other beneficiaries.
Coordinates with MTF staff, the lead RMC agent, and the military and civilian providers’ network to determine the best method to meet the individual’s needs for information or assistance and reviews medical records when needed for clarification of medical treatment, history of illness, medical test, accident information or any other clarification for billing purposes.
Provides assistance to civilian providers and others who might be involved in the care requested.
Explains the full range of available benefits and entitlements as well as eligibility requirements, options, limitations, and relationship to the Defense Eligibility Enrollment Reporting System (DEERS).
Works with others to provide enrollment assistance, beneficiary program counseling and assistance, and claims processing resolution.
Processes and coordinates referrals for the foreign population at off base civilian facilities.
Accurately refers patients to subsequent care using the most current MTF Capabilities.
Registers patients into the Medical Treatment Facility and obtains International Travel Orders (ITO) for NATO/non-NATO patients that require them with the correct billing codes and demographics.
Inputs and updates patient insurance information in CHCS, AHLTA, or MHS GENESIS, ART (Assistance Reporting Tool) and TPOCS or into other databases required by the MTF. Coordinates with Resource Management Office at the MDG and tracks all ITOs and other Status of Forces agreements for our foreign patients.
Provides patient education including, but not limited to, medical care provider in the
Medical Treatment Facility, specialty care referrals, claims procedures.
Uses other databases (internal or external to MTF) in compliance with HIPAA guidelines to identify insurance coverage.
Provides MTF clinical personnel education concerning foreign medical referral process and Timelines.
Performs other benefits advisor duties as requested by the 82 MDG
Plans daily activities within the guidelines of company policy, job description and supervisor's instruction in such a way as to maximize output.
Responsible for aiding in own self-development by being available and receptive to any training made available by the company.
Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and coworkers. Will report any unsafe conditions and/or practices to the appropriate supervisor and Human
Resources. Will immediately correct any unsafe conditions as the best of own ability.
High School diploma or General Educational Development (GED) and two (2) years’ of experience or equivalent combination of education / experience. Basic medical terminology required. Experience with administrative business programs and projects. Must have prior experience with billing, benefits counseling, and customer service preferably in the medical field. A fully qualified typist (computer keyboard) with a minimum of 40 WPM is required.
CERTIFICATES, LICENSES, REGISTRATION
Basic Life Support (BLS) certification with either the American Heart Association Basic Life Support or the American Red Cross CPR/BLS (Heart Saver) Course.
The following immunizations:
MMR (Measles, Mumps, Rubella)
Proof of a negative TB skin test within 12 months
JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES
Skilled proficiency utilizing Microsoft Windows and Office programs (i.e., Word, Excel, Outlook, PowerPoint, etc.)
Knowledgeable as to full array of employee benefits (i.e., insurances, leave, retirement, worker’s compensation, overtime pay, etc.)
Excellent verbal and written communications skills with ability to create effective reports and presentations
Ability to work and communicate effectively with all levels of management and coworkers, as well as external contacts
Exceptional customer service skills with ability to receive and provide information with clarity, courtesy and tact
Ability to apply good listening skills and to handle unusual or complex situations with a calm and focused approach
Ability to handle sensitive information with discretion and to maintain confidentiality
Ability to take initiative in carrying out recurring assignments and to work independently within the framework established by the supervisor
Detail-oriented with ability to organize work, set priorities and handle multiple priorities and responsibilities
Ability to work independently or in a team environment towards the successful achievement of goals
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
The physical demands described here are representative of those that must be met by an employee to perform successfully the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job. Work is primarily performed in an office environment. Regularly required to sit. Regularly required use hands to finger, handle, or feel, reach with hands and arms to handle objects and operate tools, computer, and/or controls. Required to speak and hear. Occasionally required to stand, walk and stoop, kneel, crouch, or crawl. Must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus. Exposed to general office noise with computers printers and light traffic.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!