Claims Customer Service Rep 2
Claims Customer Service Rep 2
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. 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. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona.
Claims Customer Service Representative 2
Salary: $27,000 - $31,000
Closing Date: 11/22/2021
The Division of Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as a Claims Customer Service Rep. 2. After a successful training period, this position will work primarily from home, with some in-office meetings and on-site duties being required. This position performs administrative work in the Claims Customer Service Unit in the division of Fee for Service Management (DFSM) in a call center environment. It is responsible for specialized work with AHCCCS providers regarding the status of their claims. Major duties and responsibilities include but are not limited to:
* In a virtual call center environment, provides technical assistance to providers and agency staff regarding billing procedures, reimbursement policies, prior authorization requirements and eligibility information.
* Research provider claims and prior authorization inquiries to provide status and identify billing, procedure, or processing problems. Refers to appropriate areas for additional claim research if needed.
* Collects documentation for resubmission of claims and prior authorizations. Assures quality of claims in each phase of the claims process.
* Prepares documentation for research and coordinates resolution of provider issues between various claims departments.
* The ability to elevate a situation/issue to a higher level.
* Multi-task in a fast-paced environment.
* Excellent verbal and written communication skills.
* Intermediate computer skills.
* General knowledge of all AHCCCS and Fee for Service Programs.
* Minimum of 1 yr. experience in medical claims processing.
* Minimum of 1 yr. medical claims customer service.
* Minimum of 1 yr. in a call center.
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan.
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-417-4497.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.