Job Description

Responsibilities

• Serves as the point of contact on matters relating to health benefits programs available to eligible beneficiaries.
• Provides advisory services on benefits offered through the TRICARE program. Provides counseling and guidance concerning TRICARE rights, benefits, and obligations.
• Troubleshoots and resolves problems for TRICARE beneficiaries and providers. Researches problems in the claims process by telephone or other methods. Advises beneficiaries of appeal rights under DoD regulations.
• Informs and educates beneficiaries regarding health care benefits. Provides benefit briefings at various installation functions such as military retirement briefings, newcomer?s briefings, commander?s calls, and spouse orientations.

Conditions of Employment

• Must complete initial online questionnaire and additional assessment(s)
• U.S. Citizenship is required
• Males must be registered for Selective Service, see www.sss.gov
• PCS expenses NOT authorized
• This posn is subject to provisions of the DoD Priority Placement Program
• Disclosure of Political Appointments

Qualifications

In order to qualify, you must meet the specialized experience requirements described in the Office of Personnel Management (OPM) Qualification Standards for General Schedule Positions, Clerical and Administrative Support Positions.

SPECIALIZED EXPERIENCE:

Applicants must have at least one (1) year of specialized experience at the next lower grade GS-06, or equivalent in other pay systems. Examples of specialized experience includes knowledge of medical legal provisions, regulations, laws, benefits and related administrative practices.

KNOWLEDGE, SKILLS AND ABILITIES (KSAs): 

Your qualifications will be evaluated on the basis of your level of knowledge, skills, abilities and/or competencies in the following areas:
1. Knowledge of standardized principles, practices, and applied techniques of various health care programs, policies and regulations and comprehensive health care delivery systems related to benefits, entitlements, and reimbursement which affect the entitlements of the beneficiary population.
2. Knowledge of pertinent rules, regulations, policies, and components of Government healthcare programs, specifically DoD and TRICARE, and their interrelationships.
3. Knowledge of claims processing procedures and processes for resolving disputed claims.