Provider Resource Center Representative / MN Health Insurance Program Representative 1

Minnesota Department of Human Services; Saint Paul (MN); On-site; USD 52,000 - 73,000; Full time

Job summary

The Minnesota Department of Human Services seeks a Provider Resource Center Representative in St. Paul. This full-time, day-shift role handles inquiries from enrolled and prospective providers about benefits, coverage, and claims, using multiple systems to deliver accurate information.

Applicants should have two years of customer service experience and strong English communication. Telework eligibility is available for Minnesota residents with approval.

Qualifications

• Two years of customer service experience.
• One year in a high-volume call center handling inquiries and meeting standards.
• Ability to administer policies, procedures, and systems used for eligibility determinations.
• Strong computer skills to navigate multiple software applications and databases.
• Excellent oral and written communication in English.

Responsibilities

• Multitask using several computer systems to retrieve information and complete calls.
• Answer questions from enrolled and prospective providers about benefits, coverage, claims, authorizations, enrollment and eligibility.
• Analyze and triage caller concerns and provide referrals or resources within guidelines.
• Balance timely service with high-quality, accurate information delivery.
• Develop relationships with provider groups and understand payment and eligibility cycles.
• Learn and apply policies and forms used in MMIS and MN–ITS systems.
• Provide step-by-step procedures with accessible explanations for callers.
• Maintain confidentiality of provider information.

Skills

Customer service

Call center experience

English proficiency

Data entry

Computer skills

Multi-tasking

Tools

MMIS system

EDI

Job description

• Telework Eligible: Yes

Working Title: Provider Resource Center Representative

Job Class: Minnesota Health Insurance Programs Representative 1

Agency: Human Services Dept

• Job ID: 96340
• Location: St. Paul
• Telework Eligible: Yes
• Full/Part Time: Full-Time
• Regular/Temporary: Unlimited
• Who May Apply: Open to all qualified job seekers
• Date Posted: 09/01/2026
• Closing Date: 09/10/2026
• Hiring Agency/Seniority Unit: Human Services Dept / DHS Central Office AFSCME
• Division/Unit: DHS-Central Office / HCA MPPS PR PCC Physician
• Work Shift/Work Hours: Day Shift
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $24.84 - $34.84 / hourly; $51,865 - $72,745 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 207 - Technical/AFSCME
• Work Area: (Required for AFSCME)
• FLSA Status: Nonexempt
• Designated in Connect 700 Program for Applicants with Disabilities: Yes

This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you'll do is more than just a job.

At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well‑being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.

Responsibilities

• Multi-tasking and analytical skills using multiple computer systems and applications open on the desktop to retrieve information from all sources to complete the call
• Answering questions from enrolled providers and prospective providers regarding a wide variety of topics including benefits, coverage, claims, authorizations, enrollment and eligibility
• Analyze, investigate, triage, resolve or assist in the resolution of the callers concerns, highly complex issues or provide additional resources, referrals or support, within given parameters
• Balance the need to expeditiously service a continuous flow of customers with a focus of ensuring quality service, excellent customer service and relaying accurate, detailed, relevant information
• Develop and maintain ongoing working relationships with provider groups, their billing practices, medical services/procedures, pharmaceuticals and claims processing cycles
• Become versed in and able to apply policy, procedures, coding and forms used in association with provider types and transactions
• Instruct providers on procedures, forms and codes used in association with MMIS and MN–ITS systems
• Provide step by step procedures with sensitivity to individual learning differences and instruct callers through processes
• Ability to maintain confidentiality regarding provider information

The incumbent must be able to perform the essential functions of the job, with or without reasonable accommodation.

Minimum Qualifications

• This posting may be used to fill multiple vacancies**
• To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month, day and year for each job held.**
• Two years of customer service experience
• One year of experience in a high volume, deadline driven and accuracy-focused call center environment answering phone calls and meeting performance and production standards
• Ability to administer policies, procedures, and systems used to make eligibility determinations
• Strong computer skills with the ability to navigate multiple software applications, databases, as well as possessing data entry skills
• Strong customer service skills and effective oral and written communication
• Ability to read, speak and write English well enough to understand, apply and explain complex eligibility policies.
• Quickly adapt to changing policies and procedures
• Ability to work within a high volume, deadline‑orientated, and accuracy‑focused program where performance and production standards must be met
• Ability to multi-task and work independently with a strong work ethic and demonstrated record of regular attendance

Preferred Qualifications

• Experience involving decision‑making and customer service responsibility within a complex policy environment (e.g. applying eligibility, insurance, health care, or service industry policy while dealing with a high volume customer base)
• Experience with the Medical Management Information System (MMIS) payment and eligibility system
• Experience with health care billing
• Experience with electronic data interchange (EDI)
• Experience working in a health care call center
• Experience with Minnesota Health Care Programs (MHCP) claims
• Familiarity with medical terminology
• Variety of experiences working effectively with others from different backgrounds and/or cultures

Additional Requirements

To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.

It is the policy of the Department of Human Services that the individual selected for this position successfully complete a background investigation prior to employment, including the following components:

• Criminal background check
• Reference check
• Fingerprinting check (MNJIS/CJIS)
• Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3 business days from the start of employment; and successfully obtain/retain CJIS certification annually.

Contact

If you have questions about the position, contact Dawn Scott at [e-mail].

Applicants With Disabilities

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email [e-mail] and let us know the support you need.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

Working together to improve the state we love

What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

Benefits

As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include

• Paid vacation and sick leave
• 12 paid holidays each year
• Low-cost medical, dental, vision, and prescription drug plans
• Fertility care, including IVF
• Diabetes care
• Dental and orthodontic care for adults and children
• 6 weeks paid leave for parents of newborn or newly adopted children
• Pension plan that provides income when you retire (after working at least three years)
• Employer paid life insurance to provide support for your family in the event of death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals

• Training, classes, and professional development
• Tuition reimbursement
• Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)

Employee Assistance Program (EAP) for work/life support

• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well‑being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies

based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.