TRICARE Provider Support Services Executive

at  International SOS

International SOS is the world’s leading medical and security services company with over 12,000 employees working in 1,000 locations in 90 countries. International SOS Government Services administers the TRICARE Overseas Program providing high-quality, accessible health care services for U.S. Military service members, family members, retirees, and other eligible beneficiaries overseas.

REQUIRED QUALIFICATIONS AND EXPERIENCE

• Language Skills: Proficiency in written and oral English and German to a business standard.
• Work Experience: Experience in a customer service or transactional environment, particularly in a customer-centric role.

ABOUT THE ROLE

Step into a vital role at International SOS, where you will provide comprehensive healthcare management and support services to beneficiaries enrolled in the TRICARE Overseas Programme (TOP). As a key member of the TRICARE Provider Support Services (TPSS) team, you will manage provider relationships within the TRICARE Germany region, offering essential education and resolving claims or billing issues. Your role is pivotal in ensuring that providers and beneficiaries receive the highest standard of service and support.
This role is also called “TRICARE Provider Support Specialist” internally.

KEY RESPONSIBILITIES

• Provider Support and Education: Serve as the primary point of contact and educator for Host Nation Providers (HNPs), delivering efficient claims and customer service.
• Enquiries and Complaints Management: Respond to telephonic or written inquiries and complaints from HNPs, addressing their roles within the TRICARE TOP Medical Treatment Facilities (MTFs).
• Claims Processing Assistance: Guide HNPs on the claims submission process, ensuring timely and accurate payment processing. Manage all aspects of invoice claims, including reconciliation and submission.
• Effective Communication: Maintain professional interactions with providers, both written and telephonic, and educate them on using the online claims portal.
• Relationship Building: Establish and maintain strong relationships with internal and external customers and suppliers, ensuring seamless service delivery.
• Record Keeping: Maintain accurate records, including statistical information and client reports, while ensuring confidentiality of all patient and client information.
• Fraud Detection: Collaborate with the Medical Department to identify and report any suspected fraudulent activities.
• Continuous Improvement: Participate in staff meetings and educational offerings, staying informed about issues that may impact service delivery.