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.

Customer Service Representative 2

Division of Member and Provider Services (DMPS)

Job Location:

Address: 801 E. Jefferson Street, Phoenix, AZ 85034

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Posting Details:

Salary: $33,519 

Grade: 15

Closing Date: Open until filled

Job Summary:

The position is responsible for identifying complex problems through research, analysis and decision-making skills and finding the correct resources for resolution. Update PMMIS and other subsystems with eligibility, enrollment, demographic, Medicare and other pertinent data. Handle call center calls, answer questions, respond to email escalations or complete problem reports or referrals. Contact other outside agencies such as DES or SSA via email when discrepancies are identified.

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.

Job Duties:

Major duties and responsibilities include but are not limited to:
• Conducts research and takes action on the most complex case discrepancies utilizing multiple and computer information systems to obtain the information necessary to further quantify the problems and to determine what action or actions need to be taken to correct the discrepancies.
• Resolves problems and reports discrepancies related to eligibility and enrollment using extensive knowledge of policies and procedures related to all AHCCCS eligibility. Following research which includes oral and written inquiries to the eligibility sources, updates systems and documents all actions taken.
• Reads, reviews and applies knowledge of AHCCCS and departmental policies, rules and procedures when working discrepancies to ensure compliance. Keeps current on new policies and procedures. Is back-up to all OCARE call centers by handling incoming calls within the established call center guidelines.
• Is a team resource to answer policy, procedural or systems related questions and helps develop desk level procedures for researching and resolving discrepancies.

Knowledge, Skills & Abilities (KSAs):

Knowledge:
• ALTCS, SSA, DES, Medicare AHCCCS and other eligibility programs and systems.
• Codes, values, logic, system processes which include HEAplus, PMMIS, Medicare, as well as other eligibility systems.
• Experience in dealing with complex types of problems and reports with each of these systems.
• Complete understanding of AHCCCS & DES policies and procedures for all categories and programs regarding eligibility and enrollment.
• Customer service techniques.
• Call center environment.
• Arizona Management System.

Skills:
• Skilled in working independently and taking initiative.
• Expectation technical, analytical, problem solving and decision-making skills.
• Interprets and utilizes complex rules and procedures.
• Strong written and oral communication skills.
• Skilled in the use of computers.
• Strong inte