Customer Service Representative 2
The State of Arizona's AHCCCS is dedicated to providing comprehensive health care to Arizonans in need. The Customer Service Representative 2 will handle complex problems, manage call center communications, and ensure compliance with eligibility and enrollment policies.
Responsibilities
- Handle incoming calls within the established call center guidelines
- 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 include 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 Standard Work Processes for researching and resolving discrepancies
Skills
- One year of experience in a multi-functional customer service environment
- Knowledge of ALTCS, SSA, DES, Medicare AHCCCS and other eligibility programs and systems
- Knowledge of 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
- 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 interpersonal skills
- Complete heavy workload and special projects quickly and accurately
- Exercise tact and positive interpersonal interactions
- Quickly grasp changes and new policy procedures and rules
- Understand multiple subsystems and to update system data accurately
- Successfully pass fingerprint background check, prior employment verifications and reference checks
- All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify)
- Experience working in medical eligibility, enrollment, claims processing or claims customer service
- Bilingual (Spanish) a plus
Benefits
- 10 paid holidays per year
- Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
- Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program)
- 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
Company Overview