Provider Services Call Center Agent

State of Arizona; United States; Hybrid; USD 32,947 - 40,268; Full time

Benefits offered by this job

Paid holidays

Paid vacation

Robust insurance plan

Retirement benefits

Job summary

The State of Arizona is hiring a Provider Services Call Center Agent. This role addresses inquiries from high-level sources and offers support to community organizations. You will effectively communicate and utilize systems to resolve complex calls.

This position allows virtual work, requiring proficiency in Arizona Medicaid programs and inbound call experiences. Benefits include paid holidays, vacation, and robust insurance options.

Qualifications

• Answer calls and resolve high-level inquiries.
• Provide technical assistance regarding billing procedures.
• Complete monthly statistical reporting as requested.

Responsibilities

• Resolve inquiries from high-level sources.
• Research complex customer concerns.
• Monitor and process requests and projects.

Skills

Inbound call center experience

Arizona Medicaid programs knowledge

Technical and analytical skills

Effective communication

Customer service techniques

Education

Two years in a customer service environment

Bilingual (Spanish) preferred

Tools

HEAplus

PMMIS

Microsoft Office Suite

Job description

Provider Services Call Center Agent

Division of Member and Provider Services (DMPS)

Job Location: 150 N. 18th Avenue, Phoenix, Arizona 85007. This position has the potential to work in a Virtual Office/Telecommute setting based on unit needs and individual meeting agency requirements.

Salary: $36,608
Grade: 16
FLSA Status: Non-Exempt
Closing Date: June 14, 2026

Job Summary

This role is part of DMPS Office of Communication Advocacy, Resolution and Enrollment’s (OCARE) specialized units dedicated to serving the Office of the Client Advocate (OCA) Community Partner Assistor Organization and/or Provider Services. The Agent resolves problems and responds to inquiries and concerns from high-level sources within AHCCCS, AHCCCS providers, state and local government entities, members, general public, and community partner organizations.

All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Major Duties and Responsibilities

• Answer calls received by DMPS OCA, Provider Services, Community Partners Assistor Organization, and resolve high-level inquiries from the Governor's office, legislature, and Senior AHCCCS leadership; adhere to established call center guidelines and agency policies.
• Research and analyze difficult calls, case discrepancies using computer information systems to resolve complex customer concerns, questions, and offer resources. Contact health plans or pharmacies to immediately resolve urgent medical needs.
• Provide technical assistance to providers and agency staff regarding billing procedures, reimbursement policies, prior authorization requirements, and eligibility information.
• Process all types of case actions, monitor and assist with processing requests, discuss projects, clarify information, resolve problems, and exchange information at all levels.
• Verify information and update systems with accurate information and other pertinent data. Prepare documents for research and coordinate resolution of issues if necessary.
• Handle all operations required to support members and the general public. Provide virtual and in-house support.
• Complete monthly, quarterly, and on-demand statistical reporting as requested.
• Actively participate in the Arizona Management System initiative within the unit, division, and agency. Attend OCARE meetings and activities.

Knowledge, Skills & Abilities (KSAs)

Knowledge:

• Inbound call center experience.
• Arizona Medicaid programs; ALTCS, SSA, DES and other eligibility programs and systems.
• Codes, values, logic, and system processes including HEAplus, PMMIS, Medicare, APEP, SMIB/HIB, and other eligibility systems.
• Handling complex problems and reports within each of these systems.
• AHCCCS policies and procedures for all categories and programs regarding eligibility and enrollment.
• Arizona Management System and standard lean practices.

Skills:

• Working independently and taking initiative.
• Exceptional technical, analytical, problem solving, and decision-making skills.
• Interpreting and utilizing complex rules and procedures.
• Effective and tactful communication, including writing, one‑on‑one contact, public speaking, listening, and providing feedback.
• Proficiency with computer systems, databases, and programs such as HEAplus, PMMIS, Docuware, Prior Authorization Internal, InvGate, APEP, RightFax, Microsoft, email, word processing and spreadsheet applications.
• Organizing materials, thoughts and prioritizing work and assignments effectively.
• Strong interpersonal skills and customer service techniques.

Abilities:

• Handle a consistent incoming workload and special projects quickly and accurately.
• Exercise tact and maintain positive interpersonal interactions.
• Grasp changes and new policies, procedures, and rules quickly.
• Understand multiple subsystems and update system data accurately.
• Meet deadlines and specified goals using discretion and good judgment.

Selective Preference(s)

• Minimum: Two years 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 process and the agency’s ability to reasonably accommodate any restrictions.
• 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
• 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

Contact Us

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.