Contact Representative

Duties

• Serve as a Health Benefits Advisor assisting a diverse beneficiary population, including active-duty family members, retired military personnel, and their families.
• Deliver informational briefings to active military units, family support groups, and civilian healthcare providers, fostering understanding of program entitlements and claims processes.
• Collect, enter, and analyze patient satisfaction and complaint data from multiple sources like the Interactive Customer Evaluation and Joint Outpatient Experience Survey generating reports.
• Research indirect patient care issues, manage TRICARE Prime Travel Entitlement and non-medical attendant travel authorizations in accordance with travel regulations.
• Direct the Customer Service Program to educate patients and staff on healthcare options, rights, and responsibilities.
• Assist beneficiaries in coordinating TRICARE benefits with other insurance plans, ensure the completeness of claims packages, and refer inquiries outside TRICARE jurisdiction.
• Design and implement a comprehensive patient advocate program to address healthcare delivery concerns, including non-medical factors affecting recovery.

Requirements

Conditions of employment

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• A Personnel Security Investigation is required.
• 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.
• Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.

Qualifications

Who May Apply: US Citizens

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 .

Specialized Experience: One year of specialized experience which includes providing guidance to diverse patient populations on healthcare benefits, entitlements, and/or coverage limitations; resolving healthcare claims disputes and billing issues; analyzing patient feedback data to identify trends and recommend improvements to service delivery; and delivering educational briefings on healthcare programs. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-7).

Education

Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.

Additional information

• Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
• You will be required to provide proof of U.S. Citizenship.
• This position requires a 1 year probationary period during which the agency evaluates your fitness and whether your continued employment advances the public interest. In making this determination, the agency may consider your performance and conduct; agency needs and interests; whether your continued employment supports organizational or Government goals; and whether it promotes the efficiency of the Federal service. Continued employment requires written certification that it advances the public interest.
• Direct Deposit of Pay is required.
• Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
• Multiple positions may be filled from this announcement.
• Salary includes applicable locality pay or Local Market Supplement.
• If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the information sheet.
• Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.
• Advanced Leave may be authorized, based on a determination that it is in the best interest of the Government.
• Position is designated as Mission Essential. The incumbent will be required to report to work during times of contingency operations, natural disasters, extreme weather or other emergency situations