What are the responsibilities and job description for the Title: Customer Service Representative 4 position at Arizona Health Care Cost Containment System?
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.
