Referral Management Coordinator; Office Automation

Job Title

Job Description

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.