Client Advocate Support Representative

Arizona Department of Administration • Phoenix, AZ

3d • Remote

About The Position

This position is part of DMPS Office of Communication Advocacy, Resolution and
Enrollment’s (OCARE) specialized units dedicated to serving the Office of the
Client Advocate (OCA) Community Partner Assistor Organization and/or Provider
Services by resolving problems and responding to inquiries and concerns from
high level sources within AHCCCS, AHCCCS providers, state and local government
entities, members, general public, and community partner organizations.

The State of Arizona strives for a work culture that affords employees
flexibility, autonomy, and trust. Across our many agencies, boards, and
commissions, many State employees participate in the State’s Remote Work Program
and are able to work remotely in their homes, in offices, and in hoteling
spaces. All work, including remote work, should be performed within Arizona
unless an exception is properly authorized in advance.

Requirements

• Inbound call center experience.
• Arizona Medicaid programs; ALTCS, SSA, DES and other eligibility programs and systems.
• Codes, values, logic, and system processes which include: HEAplus, PMMIS, Medicare, APEP, SMIB/HIB, as well as, other eligibility systems.
• Handling complex types of problems and reports within each of these systems.
• AHCCCS policies and procedures for all categories and programs regarding eligibility and enrollment.
• Arizona Management System and standard lean practices.
• Working independently and taking initiative.
• Exceptional technical, analytical, problem solving and decision-making.
• Interpreting and utilizing complex rules and procedures.
• Effective and tactful communication which includes writing, one- on-one contact, public speaking, listening, and providing feedback.
• Numerous computer systems, databases, and programs to include HEAplus, PMMIS, Docuware, Prior Authorization Internal, InvGate, APEP, RightFax, Microsoft, email, word processing and spreadsheet applications.
• Organizing materials, thoughts and prioritizing work and assignments effectively.
• Strong interpersonal skills and customer service techniques.
• Handle consistent incoming workload and special projects quickly and accurately.
• Exercise tact and maintain positive interpersonal interactions.
• Quickly grasp changes and new policy, procedures, and rules.
• Understand multiple subsystems and to update system data accurately.
• Meet deadlines and specified goals using discretion and good judgment.
• Two years of Experience in a multi-functional customer service environment.

Nice To Haves

• Experience working in medical eligibility, enrollment, claims processing, or claims customer service.
• Bilingual (Spanish) a plus.

Responsibilities

• Answer calls received by the DMPS OCA, Provider Services, Community Partners Assistor Organization, resolve high level inquiries from the Governor's office, legislature, and Senior AHCCCS leadership; adhere to established call center guidelines and agency policies.
• Researching and analyzing difficult calls, case discrepancies utilizing computer information systems to resolve complex customer concerns, questions and offer resources. Contacting health plans or pharmacies to immediately resolve issues of urgent medical needs. Technical assistance to providers and agency staff regarding billing procedures, reimbursement policies, prior authorization requirements and eligibility information.
• Processing of all types of case actions. Monitor and assist with processing requests. Discuss projects, clarify information, resolve problems, and exchange information at all levels. Analyzing and researching requests while ensuring quality.
• Verify information and update systems accordingly, if necessary, with accurate information and other pertinent data. Prepares documents for research and coordinates resolution of issues if necessary.
• Handling of all of the operations required to support our members and the general public. Provide virtual and in-house support.
• Completion of monthly, quarterly, and on-demand statistical reporting as requested.
• Actively participate in the Arizona Management System initiative within the unit, division, and agency. Actively participate in OCARE meetings and activities.

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.
• 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: No Education Listed
• Number of Employees: 501-1,000 employees