TriWest Healthcare Alliance

  • Claims Customer Service TL

    Recruiting Location Phoenix, AZ
    ID 2019-2785
  • Overview

     Work Location:  Phoenix, AZ

    Claims Customer Service Team Lead 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 Claims Customer Service Team Lead?




    TriWest Claims Customer Service Team Lead:

    Provides training, coaching, and daily direction to a team of Claim Service Representatives. Supports team by researching claims data, claim system, and authorizations to resolve provider claim questions. Places outbound calls and receives inbound calls to resolve provider claim inquiries. Directly interacts with a variety of customers daily. Serves as a back-up to CSRs to facilitate timely resolution of provider issues. Works in a detailed, multi-tasked and fast-paced production environment.


    • Works with leadership to escalate issues to the appropriate department
    • Serves as a Subject Matter Expert to Claims Customer Service Representatives
    • Assist in resolving billing issues for Veteran, and claims issues for providers
    • Responds to inquiries from Veterans and providers regarding claim billing issues. Information and assistance includes providing details regarding how claim payments were made, assisting with authorization issues, claim submission issues, and how resolution can be made
    • Investigates recurring problems for process improvements and reports on findings.
    • Assists leadership in distributing/adjusting Claim Customer Service Representative workload based on work volume.
    • Maintains updated knowledge of software applications, on-line system, Claim Customer Service Representative procedures and processes.
    • Assists Claim Customer Service Representatives Supervisors and management in tracking daily performance statistics.
    • Manages multiple task lists in accordance within directed timelines.
    • Complies with HIPAA regulations to protect privacy of beneficiaries' health information.
    • Documents all communications involving Veteran and provider contacts.
    • Coordinates complete resolution of service issues by interfacing with the TriWest Complaints & Grievance Specialist and other departments when requested.
    • Consistently meets department productivity and performance metrics.
    • Performs other duties as assigned.
    • Regular and reliable attendance is required.


    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 your High School diploma or G.E.D?
    • Do you have One year experience working in a call center?
    • Are you Proficient with Microsoft Outlook and the internet?
    • Do you have 3+ Claims processing and/or claims billing experience?
    • Do you have Strong Knowledge of medical terminology


    Do you have an Associate’s degree in healthcare or related field?

    Do you have Previous Team Lead experience?

    Do you have Claims processing background?

    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.  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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