About the Position: This position is with the Defense Health Agency. It is located within Health Benefits Department, Naval Medical Center, Portsmouth, Virginia. The primary purpose of this position is to serve as a beneficiary advocate and advisor providing customer service and counseling assistance to Military Health System beneficiaries in understanding and obtaining benefits under the TRICARE program.

Duties

Provide beneficiary counseling and assistance to ensure health benefit information is available to eligible beneficiaries. Act as liaison to assist beneficiaries regarding the TRICARE program, coordinating with medical staff, Tricare Area office service centers, Managed Care Support Contractors, claims processor, and other concerned parties. Coordinate briefings for the servicing community to include active duty, family members, newcomers, pre-deployment and post deployment. Utilize various healthcare software applications such as DEERS, to verify patient eligibility and complete patient enrollment. Track medical claim cases using a system such as Assistance Reporting Tool (ART) to categorize caseload by data elements for timely resolution. Develop recommendations to change or modify existing procedures or policies that will subsequently provide more effective and improved health care to the beneficiary category populations. Provide information to resolve problems involving access, payment of bills, and eligibility issues concerning medical care under the TRICARE program.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment. A background investigation and credit check are required.
• This position requires the incumbent to spend up to 10% of their time away from their official duty station.
• This position has a mandatory seasonal influenza vaccination requirement and is therefore subject to annual seasonal influenza vaccinations.

Qualifications

This position is a developmental GS-07 level with promotion potential to a GS-08. The position may be filled at either level GS-07 or GS-08. If selected at the GS-07 level; noncompetitive promotion to the next grade level is authorized; pending time in grade requirements and demonstrated ability to perform at the next higher/target level grade duties. Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. Current Civilian Employees of the Defense Health Agency (DHA)Current Permanent Department of Defense (DoD) Civilian EmployeeDomestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel WorkforceInteragency Career Transition Assistance PlanLand Management Workforce Flexibility ActMilitary Spouses, under Executive Order (E.O.) 13473Non-Appropriated Fund Instrumentality (NAFI)Non-Department of Defense (DoD) TransferOffice of Personnel Management (OPM) Interchange Agreement EligiblePriority Placement Program, DoD Military Spouse Preference (MSP) EligibleReinstatementVeterans Employment Opportunity Act (VEOA) of 1998 In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. GS-7 Grade Level: Specialized Experience: One year of specialized experience which includes 1) answering routine questions from beneficiaries related to medical insurance claims, such as submission, collections, and case resolution processes, 2) assisting with counseling beneficiaries on a broad range of healthcare related benefits, and 3) utilizing automated healthcare database to enter and retrieve patient data. This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-06). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06). GS-8 Grade Level: Specialized Experience: One year of specialized experience which includes 1) assisting beneficiaries by resolving or correcting discrepancies of existing medical claims, 2) providing regulatory healthcare guidance to the patient population on their rights, benefits, privileges, access to care and available eligibilities, 3) counseling beneficiaries on a broad range of available health benefit programs, such as TRICARE, Dental Programs and US Family Health plans and 4) utilizing an automated healthcare database to enter and retrieve patient data. This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-07). You will be evaluated on the basis of your level of competency in the following areas: Computer SkillsCustomer Service (Clerical/Technical)Technical Competence

Education

This job does not have an education qualification requirement.

Contacts

• Address JT-DHA-DD83DY DHA TIDEWATER MARKET DO NOT MAIL Various Locations, VA 00000 US
• Name: Army Applicant Help Desk