Member Contact Call Center Agent

State of Arizona; United States; Hybrid; USD 30,167 - 36,870; Full time

Benefits offered by this job

10 paid holidays

Paid Vacation

Paid Parental Leave

Lifetime Pension Benefits

Comprehensive insurance plans

Learning and career development opportunities

Job summary

The State of Arizona is seeking a Member Contact Call Center Agent responsible for managing complex inquiries, utilizing systems to resolve discrepancies, and providing exceptional customer service.

Ideal candidates will have significant experience in customer service and ideally in eligibility and enrollment processes. The role involves both telecommuting options and in-office presence in Phoenix, Arizona.

Benefits include a robust retirement program, paid leave, and various insurance options.

Qualifications

• Minimum of one year of experience in a multi-functional customer service environment.
• Experience working in medical eligibility, enrollment, claims processing or claims customer service preferred.

Responsibilities

• Handle incoming calls within the established call center guidelines.
• Conduct research on complex case discrepancies utilizing multiple systems.
• Update systems with eligibility and enrollment information.
• Act as backup for all OCARE call centers.
• Serve as a resource for team questions and development.

Skills

Customer service techniques

Problem-solving skills

Technical skills

Bilingual (Spanish)

Education

One year of experience in a multi-functional customer service environment

Experience in medical eligibility, enrollment, claims processing

Job description

Member Contact Call Center Agent

Location: 150 N. 18th Avenue Phoenix, Arizona 85007.

Potential Virtual Office/Telecommute setting based on the unit needs and the individual meeting agency requirements.

Salary: $33,519. Grade: 15. FLSA Status: Non-Exempt. Closing Date: June 7, 2026.

Job Summary

The position is responsible for identifying complex problems through research, analysis and decision‑making skills and finding the correct resources for resolution. Update PMMIS and other subsystems with eligibility, enrollment, demographic, Medicare and other pertinent data. Handle call center calls, answer questions, respond to email escalations or complete problem reports or referrals. Contact other outside agencies such as DES or SSA via email when discrepancies are identified.

Major duties and responsibilities

• Handle incoming calls within the established call center guidelines.
• Conduct research and take action on the most complex case discrepancies utilizing multiple 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.
• Resolve problems and report 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, update systems and document all actions taken.
• Read, review and apply knowledge of AHCCCS and departmental policies, rules and procedures when working discrepancies to ensure compliance. Keep current on new policies and procedures.
• Act as backup to all OCARE call centers by handling incoming calls within the established call center guidelines.
• Serve as a team resource to answer policy, procedural or systems related questions and help develop Standard Work Processes for researching and resolving discrepancies.

Knowledge, Skills & Abilities (KSAs)

Knowledge

• ALTCS, SSA, DES, Medicare AHCCCS and other eligibility programs and systems.
• 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.

Skills

• 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.

Abilities

• 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.

Selective Preference(s)

• Minimum: One year of experience in a multi‑functional customer service environment.
• Preferred: Experience working in medical eligibility, enrollment, claims processing or claims customer service. Bilingual (Spanish) a plus.

Pre-Employment Requirements

• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above‑mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Driver’s License Requirements if the position requires driving or the use of a vehicle as an essential function of the job to conduct State business.
• All newly hired State employees must successfully complete the Electronic Employment Eligibility Verification Program (E‑Verify).

Benefits

• 10 paid holidays per year.
• Paid Vacation and Sick time off (13 and 12 days per year respectively) – start earning on the 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.

Retirement

• Lifetime Pension Benefit Program – administered through the Arizona State Retirement System (ASRS). Defined benefit plan that provides for life‑long income upon retirement. Required participation for Long‑Term Disability (LTD) and ASRS Retirement plan. Pre‑taxed payroll contributions begin after a 27‑week waiting period (prior contributions may waive the waiting period).
• Deferred Retirement Compensation Program – voluntary participation. Program administered through Nationwide. Tax‑deferred retirement investments through payroll deductions.

Equal Opportunity & Reasonable Accommodation Statement

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing [e-mail]. Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.