Field Support Specialist

TriWest Healthcare Alliance – Boston, MA

TemporaryLocation Boston, Massachusetts Full/Part Time Full-Time Favorite Job Regular/Temporary Regular

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Field Support Specialist at TriWest Healthcare Alliance

Taking Care of Our Nation’s Veterans.

It’s Who We Are. It’s What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!

Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

Are you our next Field Support Specialist?

Do you find satisfaction in helping others? Do you enjoy working in a self-driven and dynamic environment? Do you thrive on challenge and take your responsibilities seriously? Are you looking for a job that is meaningful and rewarding?

If you enjoy problem solving, building account relationships, and delivering customer service in a collaborative environment, we have a position for you.

Our Field Support Specialists are:

  • Caring and Empathetic. You understand the needs of others and work hard to exceed their expectations.
  • Diligent. You work well within a clear set of expectations and guidelines but can overcome obstacles as needed.
  • Determined. You enjoy problem resolution and educating others to improve processes and the delivery of customer service and quality.
  • Thorough. You have a desire to get things done on time and with accuracy.
  • TriWest Field Support Specialists:

    The Field Support Specialist serves as the primary point of contact between TriWest and our customer, the VA Medical Center Care, to effectively and efficiently support Veterans receiving care from a community provider. They are trained and knowledgeable on all aspects of program operations. Field support specialists are mobile staff that work at the VAMC and from home to offer day-to-day, face-to-face support for the VA staff members and Veterans (as requested) and to coordinate operational support with TriWest operations centers and corporate functions. Daily responsibilities for the TriWest staff include research and resolution of issues related to referrals, appointments, care coordination (non-clinical), secondary authorizations, and claims. Field staff also provides supplemental training and support to VA staff on the use of the TriWest VA Portal. Field staff will also work closely with TriWest Provider Services to research and resolve any provider network issues.

  • Perform service recovery with veterans, community providers and VA Medical Center staff when there are identified errors delaying care or payment of care or associated care (Emergency room/Inpatient) Claims received from third parties
  • Working in collaboration with the local VA Medical Center Advocates office to ensure issues are not escalated to the congressional level.
  • Working with the VA Medical Center Community Managed Care Team to reduce returns, resolve and maintain referral and authorization activity. Identify gaps in the TriWest network of licensed healthcare to deliver patient-centered care and with enrollment to update and maintain enrollment and eligibility information.
  • Support community Providers, ensuring the processing and payment of claims, identifying authorizations (not received by facility); possibly modifying authorizations requiring updating (CPT codes, secondary auth request education, secondary auth request inquiries and processing.
  • Follow processes of the Department of Veterans Affairs (VA) program and perform all tasks in a courteous and professional manner.
  • Protect the health care privacy of patients by strictly following HIPAA regulations.
  • Research systems to find missing information; coordinate with other TriWest departments to resolve issues.
  • Work in a variety of technologies to perform required tasks.
  • Manage prioritized tasks in a time-sensitive environment.
  • Perform other tasks as assigned by leadership.
  • Are you qualified?

  • Are you a Veteran, family member of a Veteran, a friend of a Veteran, or passionate about helping Veterans?
  • Do you have a high school diploma or G.E.D.?
  • How about at two years in working in a healthcare or managed care environment and familiar with medical terminology?
  • Do you have two years or more working in a customer service/resolution or account management role?
  • Are you proficient with a computer including Microsoft Office, the Internet, and other systems?
  • More About Working at TriWest Healthcare Alliance

    We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Team members work from home or in one of our state-of-the-art facilities. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

  • Medical, dental and vision coverage
  • Generous paid time off
  • 401(k) Retirement Savings Plan (with matching)
  • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
  • Equal Opportunity Employer

    TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.

    Are you ready to make a difference in the lives of our nation’s heroes?

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