Customer Service Navigator (Finance)

**Must Reside in Alaska Time Zone**

Job Summary

Manages escalated and complex scenarios through chats, telephonic interaction, and electronic messaging from Customer Service Representatives, internal TriWest departments, and Defense Health Agency personnel. Provides back-up phone and payment support during periods of high inbound call volume and/or high task inventory. Works in a detailed, multi-tasked and fast-paced production environment.

Education & Experience

Required:

• High School diploma or G.E.D.
• U.S. Citizen
• Must be able to receive a favorable interim and final Department of Defense (DoD) background investigation
• At least one year of TriWest customer service experience or previous call center team lead experience within the last 3 years

Preferred:

• Health plan experience in a customer service setting
• Associate's degree or health care related certification

Key Responsibilities

• Assigned to the Navigator call queue, provides subject matter expertise (SME) by correctly answering telephonic, electronic and chat inquiries regarding operational processes and complex customer service inquiries.
• Develops and maintains TRICARE benefit knowledge, processes and procedures. Attends and masters applicable training.
• Handles escalated inquiries from staff and other departments ensuring a quick and accurate resolution to maintain internal and external customer satisfaction.
• Connects with other department designated SMEs as needed to ensure first call resolution.
• During times of excessive inbound call volumes and/or task inventory, takes inbound or makes outbound calls depending on call volume needs.
• Takes direct inbound calls from specialized populations such as BEPP, BCAC, DCAO, MMSO, DHA to resolve caller concerns or questions.
• Tracks and analyzes escalation patterns to identify common issues, knowledge gaps, or process inefficiencies, sharing findings with management to drive improvements in training, policies and workflows.
• Partners with the Training, Knowledge Management, as well as other departments to resolve the identified knowledge gaps by supporting leaders with tools and information to resolve concerns.
• Maintains updated knowledge of software applications, on-line systems, Customer Service Representative procedures and processes.
• Assists Customer Service Representative leaders in tracking learning opportunities and Navigator Support Desk utilization.
• Supports the leadership teams through data and program knowledge. Coaches to correct responses but does not performance coach/lead.
• Documents all communications involving customer contacts.
• Coordinates complete resolution of service issues by interfacing with the TriWest Complaints & Grievance Specialists, Military and Veteran's Services (MVS), and DHA, other departments when requested.
• Consistently contributes to the achievement of department productivity and performance metrics.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to unique styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Knowledge of TriWest policies, processes, and procedures, knowledge of call management methodology.

Working Conditions

Working Conditions:

• Ability to cover any work shift with no travel
• Works within a standard office or virtual environment
• Extensive computer work with prolonged sitting and wearing of headset
• Security clearance required

Company Overview

Taking Care of Our Nation's Heroes.

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.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

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
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $43,000 - $55,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.