Professional Relations TriCare Support Rep

About the position

As a Professional Relations TRICARE Support Representative at Blue Cross and Blue Shield of Kansas, you will play a crucial role in providing administrative support to the TRICARE Professional Relations Representative and the Government Programs Professional Relations Manager. Your primary responsibility will be to ensure the prompt, courteous, accurate, and timely handling of incoming TRICARE-related telephone calls, emails, and written correspondence from professional provider offices and internal staff. This position is essential in maintaining effective communication and support for our providers, ensuring they receive the assistance they need to navigate the complexities of TRICARE services. In this role, you will be expected to manage a variety of tasks, including reviewing and imaging provider contact reports initiated by the representative, following up on assigned activities, and resolving claims payment problems, coding issues, and membership inquiries. You will need to be proficient in using Salesforce to monitor TRICARE contracting and provide feedback to the manager and representative to optimize provider participation. Your ability to handle interruptions throughout the day while maintaining a high level of service will be critical. You will also be responsible for educating providers on correctly coding their CMS 1500 claim forms, researching claims payment and coding problems, and coordinating the provider listing for the TRICARE representative. Additionally, you will assist in scheduling and coordinating workshops, managing provider contracts, and providing backup support for the Professional Relations team as needed. This position offers a dynamic work environment where you can collaborate with a passionate team dedicated to making a difference in the healthcare community.

Responsibilities
? Provide administrative support for the TRICARE Professional Relations Representative.
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? Handle incoming TRICARE-related telephone calls, emails, and written correspondence.
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? Review and image provider contact reports initiated by the representative.
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? Research and resolve claims payment problems, coding issues, and membership inquiries.
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? Be proficient in using Salesforce to monitor TRICARE contracting and provide feedback to the manager and representative.
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? Educate providers on correctly coding their CMS 1500 claim forms.
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? Research claims payment and claim coding problems and refer inaccurately processed claims for adjustment.
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? Coordinate and maintain the provider listing for the TRICARE representative.
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? Schedule, coordinate, and assist with workshops as assigned by the provider representative.
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? Manage and update contract status in Salesforce.

Requirements
? High School graduate or equivalent required.
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? Two (2) years prior ICD-10 or CPT coding knowledge or experience required OR two (2) years experience within the organization's operational areas working as a customer experience representative, claims processor, membership representative, PNS call center & enrollment representative, or similar experience.
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? Proficiency in the use of WORD and EXCEL strongly preferred.
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? Proficiency in using mainframe applications strongly preferred.
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? Knowledge of the BlueCard Program and managed care programs is preferred.

Nice-to-haves
? Experience in customer service or healthcare support roles.
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? Familiarity with TRICARE policies and procedures.

Benefits
? 401(k) with 5% match
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? Adoption assistance
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? Caregiver leave
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? Dental insurance
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? Gym membership
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? Health insurance
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? Incentive pay program (EPIP)
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? 6 weeks paid parental leave for new mothers and fathers
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? Fertility/Adoption assistance
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? 2 weeks paid caregiver leave
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? Tuition reimbursement
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? Health & fitness benefits, discounts and resources

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