Referral Management Coordinator (Office Automation)

Summary

About the Position: This position is located within the Patient Administration Service Department at Army Health Clinic Fort Detrick in Frederick, Maryland. This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD to recruit and appoint qualified candidates to positions in the competitive service.

Duties

• •Coordinate patient arrangements and serves as liaison between civilian providers, the MTF, and the managed care support contractor on administrative matters related to the referral process.
• •Track medical consults deferred to the network and resolves issues related to consult process.
• •Collect, consolidate, and monitor a wide range of supplemental health care data.
• •Ensure bills received are appropriate for payment using Supplemental Health Care Funds (SHCF) or PT benefits funds and have been submitted with appropriate Current Procedural Terminology (CPT) coding, and other supporting documentation.
• •Utilizes Defense Travel System (DTS) to assist travelers not issued a common access card (CAC) under the TRICARE prime travel program for medical travel reimbursement as T-Entry agent.
• •Counsel beneficiaries concerning TRICARE rights, benefits, and obligations.
• •Provide information to civilian hospitals, clinics, and offices concerning authorized treatments, eligibility criteria, and payment procedures.
• •Disseminate information concerning policy and procedural changes of Active Duty TRICARE Program to the Referral Management and Clinical Operations staff.

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 in this document. Specialized Experience: One year of specialized experience which includes processing medical referrals; reviewing healthcare claims; and advising beneficiaries on healthcare benefits. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). 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. Proficiency Required: This position requires a qualified typist. A qualified typist can type 40 words per minute based on a 5 minute sample with three or fewer errors.