AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

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.

Provider Enrollment Customer Service Representative

Division of Member and Provider Services (DMPS)

Job Location:

Address: 150 N. 18th Avenue Phoenix, AZ 85007

This position offers the opportunity for full-time remote work. However, based on business needs, occasional in-office attendance or in-person customer visits may be required.

Posting Details:

Salary: $38,499 

Grade: 17

FLSA Status: Non-Exempt

First Review of Resumes: April 7, 2026

Job Summary:

This position is responsible for conducting Provider Enrollment. On-Site Visits, Provider facility compliance with CMS Medicaid facility requirements, providing assistance, guidance, and answering questions. during enrollment/application process for AHCCCS Providers. Will assist Providers with application packets in person and over the phone. Interview and question providers to elicit information necessary to determine CMS criteria being met for applicant provider type.

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.

Major duties and responsibilities include but are not limited to:
• Assisting AHCCCS Providers in processing their application, answering questions and collecting information. Assisting over 100 different provider types and knowledge of eligibility criteria for each provider type.
• Site Visits, both individually and in a team of 2, depending on the scope of the visit and distance. Visits will determine the enrollment of services being provided by Provider. Determine that Services, Offices, and equipment are operable and match information provided on the application completed by Provider.
• Determining eligibility of Provider based on CMS guidelines. Research provider demographics in PECOS, follow CMS audit process/guidelines regarding compliance of Medicare Debt and billing practices and encounters.
• Assess risk level and in depth screening of Providers to ensure excluded providers are eliminated from Medicaid Enrollment Compile all documents for Provider disciplinary action for AHCCCS Medical Review board.
• Act as an AMS Team Lead on projects and presentation of section's statistics. Share Assignment results with the team, suggest process flow changes. Interpret policy and procedure changes. Assist with training new staff by providing on the job training techniques, and mentorship
• Studying statutes, rules, policy manuals and clarifications. attending training and conferring with supervisor and others to improve skills and maintain expert level of knowledge.

Knowledge, Skills & Abilities (KSAs):

Knowledge:
• Computer systems to include word processing, spreadsheet, email and database applications.
• Medicaid Programs and Prepaid Medical Management Information System (PMMIS) and/or PECOS.
• Expert knowledge of CMS State statute
• Rules and regulation relating to the determination of eligibility to become an AHCCCS Provider
• AHCCCS Provider Enrollment Portal, APEP

Skills:<