Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
OPEN TO AHCCCS EMPLOYEES ONLY
Claims Customer Service Rep 3
First Resume Review 4/22/2019
This position will remain open until filled
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility.
All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results. State employees are highly engaged, collaborative and embrace a culture of public service. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!
The Division of Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as a Claims Customer Service Representative 3. Interact with customers in the Division of Fee For Service Management (DFSM) Claims Customer Service Unit to provide information in response to inquiries about products and services and to handle and resolve complaints regarding their claims. Major duties and responsibilities include but are not limited to:
* Confers with customers by telephone to provide information about their claims.
* Researches provider claims inquiries to provide status and identify billing, procedure or processing issues. Refers to appropriate areas for additional claim research as needed.
* Collects documentation for resubmissions of claims and assures quality of claims in each phase of the claims process.
* Exercises discretion to interpret and apply customer service procedures, prepares documentation for research and coordinates resolution of provider issues between various claims departments.
* Performs lead customer service activities by providing assistance, guidance, and instruction to less experienced Customer Service Representatives regarding the most complex customer service inquiries and issues. Attends Information Meetings within DFSM to give and receive training.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Knowledge of applicable program rules, regulations, policies and procedures systems, and relevant statutes.
* Knowledge of the principles and processes for providing customer service.
* Skill of talking to others to convey information effectively.
* Skill of Listening by giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
* The ability to interpret and apply policies, procedure, and regulations.
* The ability to multi-task in a fast paced environment.
* Minimum of one (1) year experience in Medical Claims Processing.
* Minimum of one (1) year Medical Claims Customer Service.
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. Click here to learn more about benefits.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 417-4497. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. AHCCCS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
Click the APPLY NOW button to submit your application.
For technical assistance, email HRIShelpdesk@azdoa.gov or call 602-542-4700.