Benefits and Eligibility Specialist

Arizona Department of Administration • Phoenix, AZ

1d • $41,693 • Remote

About The Position

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team. This position offers the flexibility to work remotely on a full-time basis. However, in-office presence may be required on occasion, based on business needs or operational requirements.

Requirements

• A call center environment.
• Medicare and Medicaid Programs.
• State and Federal rules and statutes.
• ALTCS, SSI MAO, Medicare Savings, KidsCare, Speciality Medicaid, and the FTW financial eligibility policies and procedures.
• Budget calculations used to determine eligibility.
• Community resources.
• Arizona Management System (AMS).
• Written and verbal communication.
• Conducting research.
• Investigative interviewing techniques.
• Two way interaction and exchange of information with customers either face to face or over the phone.
• Interpersonal relationships.
• Problem solving and decision making.
• Manage multiple tasks in a caseload.
• Self-prioritize job functions as needed.
• Mathematical calculations.
• Phone etiquette.
• Organize and prioritize a caseload.
• Communicate both verbally and in writing.
• Effectively document actions taken and decisions made.
• Accurately calculate mathematical equations.
• Apply current laws, rules and regulations in making eligibility determinations.
• Determine share of cost amounts.
• Interview effectively when dealing with all community populations.
• Apply customer service techniques; empathy, active listening, and remaining calm during customer interactions.
• Efficiently interact with family members and other entities.
• Effectively organize and prioritize tasks.
• Use logic and problem solving techniques.
• Analytical skills.
• Use numerous computer databases, systems, and programs to include HEAplus, PMMIS, ACE, FORTIS, AZTEC, RightFax, Microsoft, email and word processing applications.
• Work with minimal supervision.
• Work in an inbound automatic call distributor (ACD) environment.
• Must have a high school diploma or General Equivalency Diploma (G.E.D.)
• 6 months customer service related work experience.
• Must successfully pass a test appropriate to area of assignment.
• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Nice To Haves

• 1 year customer service related work experience.
• Bilingual (Spanish) a plus but not required.
• Chinle office only: Bilingual (fluent) in Navajo.

Responsibilities

• Completing financial eligibility determinations for ALTCS, SSI MAO, Medicare Savings, KidsCare, Specialty Medicaid and the FTW programs following productivity, timeliness, and quality guidelines.
• Scheduling and conducting interviews.
• Communicate with customers after the interview to include requesting information, status updates and final decision.
• Requesting eligibility verification from multiple sources and reviewing documentation in various systems.
• Researching, following, and applying prescribed policies and procedures.
• Documenting throughout the application process as needed, actions taken, relevant case information, and eligibility related material in case records until final case determination is made using HEAplus system.
• Participate in team meetings, AMS Process improvement, and assisting with special projects.

Benefits

• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED