Contact Representative

Full Job Description

About the Position: This position serves as a Contact Representative within Naval Hospital Jacksonville providing specialized assistance, counseling, and individualized guidance concerning the Uniformed Services Health Benefits Program (USHBP) including the TRICARE health care program.

Hours of work are 7:30 A.M. to 4:00 P.M. This is a Direct Hire Solicitation 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 equivalent to at least the GS-06 grade level in the Federal service which includes performing one or more of the following: serving as a point of contact related to healthcare benefits program matters; utilizing automated health records systems to review and maintain patient records; and communicating effectively with customers, patients, and medical staff.

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. Major Duties:

• Explain the order of priority of entitlement to benefits from other sources such as VA, Medicare, and insurance through employment and/or private insurance.
• Provide specific advice on all eligibility requirements, exclusions of certain diseases or conditions, coverage of medical conditions, out of pocket cost, coordination of benefits, and any applicable program rules.
• Explain the referral process and clear and legible report uploading.
• Interview personnel by telephone and in person to obtain information concerning military status of the sponsor.
• Provide counseling and guidance concerning TRICARE rights, benefits, and obligations.
• Advise beneficiaries of appeal rights under DoD regulations.