What are the responsibilities and job description for the Customer Service Representative 4 position at Arizona Department of Administration?
Customer Service Representative 4
Job No : 531097
Work Type : Full-time
Location : REMOTE OPTIONS, PHOENIX
Categories : Administrative Support / Customer Service
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 4
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 : $38,499
Grade : 17
First Review of Resumes : January 14, 2025
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.
Job Duties :
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 :
Skills :
Abilities :
Selective Preference(s) :
Arizona Driver's License
Minimum : Two and a half years of experience in a multi-functional customer service environment.
Preferred : Experience working in medical eligibility, enrollment, claims processing or claims customer service. Bilingual (Spanish) is a plus.
Pre-Employment Requirements :
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply : Driver's License Requirements.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Benefits :
Among the many benefits of a career with the State of Arizona, there are :
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work / life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page
Retirement :
Lifetime Pension Benefit Program
Deferred Retirement Compensation Program
Contact Us :
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity / Reasonable Accommodation Employer.
Advertised : 09 Jan 2025 US Mountain Standard Time
Applications close :
Salary : $38,499
