Provider Services Call Center Agent

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 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 offers career opportunities at all levels with various fields, entry-level positions, and internships.

150 N. 18th Avenue, Phoenix, Arizona 85007. This position may work in a Virtual Office/Telecommute setting based on unit needs and meeting agency requirements.

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

• Answer calls received by the DMPS OCA, Provider Services, Community Partners Assistor Organization, 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. Analyze and research requests while ensuring quality.
• Verify information and update systems accordingly, if necessary, 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 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.

• Work independently and take initiative.
• Exceptional technical, analytical, problem‑solving, and decision‑making abilities.
• Interpret and utilize 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 including HEAplus, PMMIS, Docuware, Prior Authorization Internal, Inv Gate, APEP, Right Fax, Microsoft productivity applications.
• Organize materials, thoughts, and prioritize work and assignments effectively.
• Strong interpersonal skills and customer service techniques.

• Handle consistent incoming workload and special projects…