Provider Services Call Center Agent

Arizona Department of Administration•Phoenix, AZ

1d•$36,608•Hybrid

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 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)
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

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