Provider Services Call Center Agent

AHCCCS

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 excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. The agency is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry‑level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.

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: $36,608 Grade: 16 FLSA Status:
Non‑Exempt First Review of Resumes:
February 17, 2026 Closing Date:
February 20, 2026

This position 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 by resolving problems and responding to inquiries and concerns from high‑level sources within AHCCCS, AHCCCS providers, state and local government entities, members, general public, and community partner organizations.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

• Answer calls received by the 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 and case discrepancies using computer information systems to resolve complex customer concerns and provide resources. Contact health plans or pharmacies to immediately resolve issues of 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. Analyze and research requests while ensuring quality.
• Verify information and update systems accordingly with accurate data. Prepare documents for research and coordinate resolution of issues if necessary.
• Handle all operations required to support our 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. Actively participate in OCARE meetings and activities.

• Inbound call center experience.
• Arizona Medicaid programs; ALTCS, SSA, DES and other eligibility programs and systems.
• Codes, values, logic, and system processes which include: HEAplus, PMMIS, Medicare, APEP, SMIB/HIB, and other eligibility systems.
• Handling complex types of 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.

• Working independently and taking…