Tricare Network Access Clerk

Position name: Tricare Network Access Clerk

Location: Osan Air Force Base, South Korea

General Information:

• Candidate provide administrative and instructional service and support
  for the 51st Medical Group (MDG) at the Referral Management Center (RMC) at
  Osan Air Force Base, South Korea

Qualification for Employment:
   Minimum Requirements:

• Have a minimum of three (3) years of experience within the last five (5) years providing service in Referral Management, Hospital Administration, Healthcare Administration and in medical customer service/liaising with providers, with patients at MTF or equivalent treatment facility which is in US medical system.
• High school diploma or General Educational Development (GED)

Specific Tasks:

• Review initial specialty care and deferred to network primary care referrals to the Brian D. All good Army Community Hospital (BDAACH) for administrative completeness. The referral process shall be started within one (1) business day from the date the referral was made. Coordinates with referring providers and BDAACH clinical staffs in cases where additional referral information is required.
• Verify patients are registered in CHCS and Defense Enrollment Eligibility Reporting System (DEERS); updates demographic information as needed. Obtain current, accurate contact information (i.e., cell/home phone number/email address).
• Assist with determinations for specialty care that can be provided within the 51 MDG using Service Availability (Capability) with checking the Right Of First Refusal (ROFR) management and other business processes as necessary.
• Schedule specialty referral appointments to MTF or Other Direct Care System (ODCS) (if allowed) using correct CHCS booking procedures, ATC standards and established clinic capability/ booking protocols.
• Coordinate with specialty referral clinics (e.g., internal MTF, ODCS, on special patient instructions and tests required prior to appointment.
• Assist team members in providing pre-appointment instructions to patients as indicated by the BDAACH.
• Submit referrals to the Chief of Medical Staff of 51 MDG, SGH, or designee for medical necessity and appropriateness review.
• Generate and forward referral-related phone consult requests received from patients to the appropriate provider/team.
• Assist communication between beneficiaries, primary care manager (PCM) team members, the BDAACH and ancillary health care workers regarding management of all referral questions/concerns.