Arizona Health Care Cost Containment System (AHCCCS)

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at Arizona Health Care Cost Containment System (AHCCCS)

Pay: up to $35,000/year
Posted: 10/9/2020
Job Reference #: 59134
Categories: Customer Service
Keywords: customer

Job Description

10/09/2020 10/21/2020
PHOENIX 35,000.00-0.00

Arizona Health Care Cost Containment System

Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork

Customer Service Representative 4 - Provider Enrollment

Apply By: October 18, 2020

Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive 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 Member and Provider Services (DMPS) is looking for a highly motivated individual to join our team as a Customer Service Representative 4. This position is responsible for conducting Provider Enrollment. On-Site Visits, Provider facility compliance with Center for Medicare (CMS) and Medicaid Services. Major duties and responsibilities include but are not limited to:

* Assisting AHCCCS Providers in processing their application, answering questions, collecting information.

* 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 Provider to ensure excluded providers are eliminated from Medicaid Review board.

* Studying statutes, rules, policy manual and clarifications. Attending training and conferring with supervisor and others to improve skills and maintain expert level of knowledge.

* Potentially 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.

* Phase 1 of the candidate selection process requires completion of a writing exercise within a required timeframe. Candidates are contacted by email.

* Due to COVID-19 precautions the recruiting process has been adjusted to meet the standard health guidelines outlined by the State. Interviews will be conducted virtually and may also be by way of video conference utilizing a platform like Google Meet/Hangouts or WebEx.


* Expert knowledge of CMS State statute.

* Knowledge of rules and regulation relating to the determination of eligibility to become an AHCCCS Provider.

* Knowledge of AHCCCS Provider Enrollment Portal (APEP)

* Ability to listen, comprehend and offer guidance to questions surrounding Medicaid enrollment through in-person or telephonic interviews.


* There years experience utilizing CMS guidelines, experience processing encounters, applications or PMMIS Healthcare background.


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 or call 602-542-4700.

Application Instructions

Please apply for this position by following the link provided below. A new window will open on your screen and you will be directed to the Arizona Health Care Cost Containment System (AHCCCS) employment website.