Benefits Eligibility Specialist Advanced

Apply now Job no: 535022
Work type: Full-time
Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX
Categories: Administrative Support/Customer Service

AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

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. Among government agencies, AHCCCS 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.

Come join our dynamic and dedicated team.

Benefits Eligibility Specialist Advanced

Division of Member and Provider Services (DMPS)

Job Location:

Address: 150 N 18th Avenue Phoenix, Arizona 85007

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Posting Details:

Salary: $46,000 

Grade: 20

FLSA Status: Non-Exempt

First Review of Resumes: August 5, 2025

Job Summary:

The position is responsible for the oversight of various assignments that support the Provider Enrollment (PE) production units and Health Program Manager II’s that make PE determinations. This person will review escalated customer situations, provider disciplinary actions, and bring issues to the appropriate level for solution. Coordination of inter-agency and intra-agency endeavors is also needed as well as interacting with other state agencies, and the AHCCCS provider community.

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.

Job Duties:

Major duties and responsibilities include but are not limited to:

• Support day to day operations with Provider Enrollment Customer Service Representative 4 positions working with enrolling and maintaining 90,000 Providers and the AHCCCS Provider Enrollment Portal (APEP). Assign and track on-site visits.
• Research and resolve issues on escalated and urgent provider inquiries. Provide high level technical assistance for all issues related to Provider Enrollment. Provide internal and external customer service resulting from general inquiries from the Director’s office and AHCCCS management.
• Create, track, and maintain Provider Enrollment reports with analysis for various Provider Enrollment tasks, including but not limited to Board Restrictions, Medical Reviews, Site Visits, Enrollment Fee, and FingerPrint Criminal Background checks.
• Develop training materials and facilitate training to providers to enhance knowledge of the APEP.
• Represent the Provider Enrollment unit in settings within and outside of AHCCCS, including AHCCCS hearings related to Provider Enrollment. Participate in and/or contribute to the Arizona Management System (AMS).

Knowledge, Skills & Abilities (KSAs):

Knowledge of:
• Conducting research, troubleshooting, problem solving and root-cause Analysis.
• AHCCCS and Provider Enrollment regulations and screening requirements.
• Developing and presenting Provider instructional training.
• Arizona Management System (AMS)
• Research and analysis methods and techniques.
• Supervised care concepts and practices.
• Automate systems and interactions/ dependencies of systems.

Skill in:
• Interpersonal communication both written and verbal.
• Negotiating and tactful explanations
• Planning.
• Interpreting and applying policies and procedures.
• Decision making
• Computer software: Word, Excel, and presenting through virtual platforms; PMMIS and APEP.

Ability to:
• Train and explain concepts.
• Problem solve customer service issues in AHCCCS Provider Enrollment Portal (APEP) and Provider Medicaid Management Information System (PMMIS).
• Multitask and prioritize multiple assignments.
• Think analytically, collect, summarize and prepare reports.

Selective Preference(s):

Arizona Driver's License

Minimum: Must have a high school diploma or General Equivalency Diploma (G.E.D) and 3 years of customer service experience.

Preferred: Two years of work experience equivalent to a Benefit & Eligibility Specialist or Program Services Evaluator (e.g., interviews and determines eligibility for public assistance benefits)

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.
• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

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. Learn more about the Paid Parental Leave pilot program here.
• 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.

Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

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 careers@azahcccs.gov.
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.

Advertised: US Mountain Standard Time
Applications close:

Back to search results Apply now Refer a friend