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Working Knowledge of the military health care system including TRICARE health benefits. Certification: Certified/certification eligible by the American Nurses Credentialing Center (ANCC) as a Psychiatric and Mental health Nurse with 2 years full time experience in mental health.
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Maintains a workable knowledge regarding specifications in billing Medicare, Medicaid, Tricare and Commercial: monitoring those accounts to meet specifications. Communicates with the AR Manager regarding problem areas.
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Responsible for supporting Federal Supply Schedule (FSS)/Veteran Affairs contracting and Tricare program. Manager Responsible for management of the Federal Supply Schedule/Veteran Affairs contracting and Tricare program.
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Medicare Tricare/Champus reports. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
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Receive telephone, written, fax, and e-mail inquiries concerning TRICARE eligibility, benefits determinations, and claims adjudication questions or billing problems. Answer inquiries from beneficiaries, providers, and other affiliated representatives or groups regarding TRICARE eligibility, benefit determinations, and claims adjudication questions or problems.
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Maintain knowledge of State and Federal specific laws, Tricare/Governmental programs, Medical Insurance Providers, Medicaid Waiver Programs and ensure compliance with regulations. Maintain knowledge of State and Federal specific laws, Tricare/Governmental programs, Medical Insurance Providers, Medicaid Waiver Programs and ensure compliance with regulations.
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CTR TAAs coordinate with appropriate Veterans Affairs, TRICARE, Veteran Service Organizations, and other resources to provide required information and assistance. TRICARE programs and policies.
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Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
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Must have working knowledge of DOD, Federal, State, non-profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid, VA, Public Health Department, and Regional and local support services.
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Priority issue areas include: Medicaid, CHIP, private insurance, children’s mental health, pediatric workforce, Children’s Hospital Graduate Medicaid Education Program, access to pediatric drugs, federal 340B Drug Pricing Program, TRICARE, price transparency, pediatric quality measurement, and pediatric disaster preparedness.
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The AVP, Quality Improvement and Performance will develop, maintain, own and execute strategies to improve performance of the TRICARE contract and maintain performance under Humana Government Business's (HGB) Clinical Quality Management Program.
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Documents in CHCS, explains appropriate options to patients when they refuse appointments within access to care (i.e. point of service, Tricare Select, be connected to Beneficiary Counselor and Assistance Coordinator.
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Strong familiarity and understanding of the CHCS, TRICARE Region 1 Policies, and Department of Defense Health Affairs guidance. Possess knowledge of the Military Health Care System, TRICARE, medical terminology, release of medical information, and legal ethics.
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As TriWest’s hybrid cloud and cybersecurity services partner, IBM is responsible for the delivery of the TRICARE Managed Care Support (MCS) T-5 contract. As TriWest’s hybrid cloud and cybersecurity services partner, IBM is responsible for the delivery of the TRICARE Managed Care Support (MCS) T-5 contract.
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Oversee development and maintenance of a comprehensive community engagement plan for both active, retirees and the Tricare population. Responsible for FEP's engagement with federally focused associations supporting both Federal employees, Tricare and active-duty populations to build awareness of the BCBS and FEP brands within these communities.
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tricare job in Arlington, VA
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