Provider Enrollment Customer Service Representative

Arizona Health Care Cost Containment System (AHCCCS)

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost‑effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for workplace effectiveness and flexibility. Employees are passionate, committed to high performance, and dedicated to serving the citizens of Arizona.

It is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals, entry‑level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team.

Address: 150 N. 18th Avenue Phoenix, AZ 85007

This position offers the opportunity for full‑time remote work. However, based on business needs, occasional in‑office attendance or in‑person customer visits may be required.

• Salary: $38,499
• Grade: 17
• FLSA Status:
  Non‑Exempt
• First Review of Resumes:
  January 7, 2026

This position is responsible for conducting Provider Enrollment, on‑site visits, and ensuring provider facility compliance with CMS Medicaid facility requirements. The Representative provides assistance and guidance and answers questions during the enrollment/application process for AHCCCS Providers. The role assists providers with application packets in person and over the phone, interviews and questions providers to elicit information necessary to determine whether CMS criteria are met for applicant provider type.

• Assist AHCCCS Providers in processing their application, answering questions and collecting information; assist more than 100 different provider types and maintain knowledge of eligibility criteria for each provider type.
• Conduct site visits, both individually and in a team of two, depending on scope and distance; determine enrollment of services, and verify that services, offices, and equipment are operable and match application information.
• Determine eligibility of providers based on CMS guidelines; research provider demographics in PECOS and follow CMS audit process/guidelines regarding compliance of Medicare debt and billing practices.
• Assess risk level and conduct in‑depth screening to ensure excluded providers are eliminated from Medicaid enrollment; compile all documents for provider disciplinary action for the AHCCCS Medical Review board.
• Act as an AMS Team Lead on projects and present section statistics; share results with the team, suggest process flow changes, interpret policy and procedure changes, and assist with training new staff.
• Study statutes, rules, policy manuals, and clarifications; attend training and confer with supervisors to improve skills and maintain expert knowledge.

• Computer systems including word processing, spreadsheets, email and database applications.
• Medicaid Programs and Prepaid Medical Management Information System (PMMIS) and/or PECOS.
• Expert knowledge of CMS State statutes.
• Rules and regulations relating to eligibility determination for AHCCCS Providers.
• AHCCCS Provider Enrollment Portal, APEP.

• Interpretation of written and verbal information.
• Problem‑solving and troubleshooting skills with research methodologies.
• Independent working skills requiring minimal supervision; effective interviewing techniques and verbal/written communication.
• Basic computer skills; proficiency with Google and/ or word processing, spreadsheet and database applications, and proprietary healthcare computer systems such as APEP.
• Good communication skills when interacting with internal and external entities.

• Work within a team environment.
• Function effectively in an orderly and purposeful manner under stress or tension.
• Work with the public in less than ideal conditions.
• Handle multiple tasks simultaneously.
• Listen,…