CONTACT REPRESENTATIVE (Temporary NTE 2 YEARS) Pyong Taek, South Korea Ausschreibungsbereich All current USFK KN employees serviced by Area III & North CPAC, CHRA-FER.

Hauptaufgaben Assistant to the Lead Referral Specialist, responsible for the referral management process in the primary and specialty clinics at BDAACH.

Provide an administrative review and screening of all referrals entered by the providers within the facility, using established system policies and referral guideline criteria.

Required to be familiar with the referral process including DHA Access to Care Standards, TRICARE platforms/data systems, , MHS GENESIS and referral management tracking system reports that monitor and both Military Treatment Facility (MTF) and civilian network referrals.

Resolves all discrepancies in the referrals directly with the appropriate provider.

Act as a liaison between the Managed Care Support Contractor (MCSC) and submitting provider to resolve these discrepancies in a timely manner.

Contacts providers or other personnel to explain or obtain information regarding referrals.

Tracks the beneficiaries, high profile and other special category patients to access healthcare in a timely manner by way of telephonic contacts and periodic checks of computer information maintained in the MHS GENESIS.

Maintains current data on the availability of specialty care within the MTF.

Assists in developing and maintaining data capture tools and systems which facilitate the multi-dimensional manipulation of referral management, appointing and access-to-care data allowing for the evaluation of processes for improvement.

For referral management ensures timely and accurate internal referral screening and appointing as well as timely coordination with the MCSC for all referrals requiring external appointments and external referrals requiring internal review.

Reviews referrals for completeness, accuracy, and compliance with regional referral business rules, covered benefits, and pre-authorization/pre-certification requirements prior to processing and sends to the MCSC.

Runs daily/periodic reports regarding referrals to ensure follow-up with the patient regarding making appointments.

Uses data analysis to recommend modifications to appointing and referral procedures, staffing, and equipment, and to clinic operations.

Performs other duties as assigned.

Qualifikationsanforderungen Auswahlkriterien auswählen Beschäftigungsbedingungen