Member Contact Call Center Agent

Member Contact Call Center Agent

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

This position has the potential to work in a 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: August 31, 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 include but are not limited to:

• Handle incoming calls within the established call center guidelines.
• Conducts research and takes action on the most complex case discrepancies utilizing multiple and 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.
• Resolves problems and reports 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, updates systems and documents all actions taken.
• Reads, reviews and applies knowledge of AHCCCS and departmental policies, rules and procedures when working discrepancies to ensure compliance. Keeps current on new policies and procedures. Is back-up to all OCARE call centers by handling incoming calls within the established call center guidelines.
• Is a team resource to answer policy, procedural or systems related questions and helps 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.

Benefits: Among the many benefits of a career with the State of Arizona, there are:

• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) start earning it your 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

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.