Working Title: Provider Resource Center RepresentativeJob Class: Minnesota Health Insurance Programs Representative 1Agency: Human Services Dept
Who May Apply : Open to all qualified job seekers
Date Posted : 04/19/2024
Closing Date : 04/25/2024
Hiring Agency/Seniority Unit : Human Services Dept / DHS Central Office AFSCME
Division/Unit : Health Care Administration / Medicaid Payment and Provider Services
Work Shift/Work Hours : Day Shift / 8:00am - 4:30pm
Days of Work : Monday - Friday
Travel Required : No
Salary Range: $22.26 - $31.38 / hourly; $46,478 - $65,521 / annually
Classified Status : Classified
Bargaining Unit/Union : 207 - Technical/AFSCME
Work Area : G - Member and Provider Services
FLSA Status : Nonexempt
Telework Eligible : Yes
Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : Yes
The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment.Make a difference in the lives of Minnesotans.The work you’ll do is more than just a job. Join the talented, engaged and inclusive workforce dedicated to creating a better Minnesota.This posting will be used to fill multiple vacancies.As a MN Health Insurance Rep 1 you will work in a heavy volume, customer service-oriented work environment, expeditiously triaging and responding to caller needs in accordance with set standards and call management practices. You will balance the need to service a continuous flow of customer calls with the importance of conducting thorough research, providing quality services and excellent customer service, and ensuring relevant, accurate information.This position requires the incumbent to answer approximately 80-120 calls per day from health care providers. The incumbent identify and respond to caller needs, within given parameters. Provide referrals to other locations within DHS, counties, and other state agencies, only if needed to obtain specialized or specific types of information/services.Responsibilities include:· Investigate and resolve and/or facilitate resolution of simple to highly complex problems reported by health care providers, members or other entities relating to MNsure, MHCP and managed care plans.· Navigate through various systems to obtain needed recipient and provider information; track transactions through historical claims data to isolate the problem/error and determine needed corrections and/or actions.· Develop and maintain ongoing working relationships with member and provider Groups, their billing practices, recipient populations, medical services/ procedures, pharmaceuticals, and claims processing cycles.· Instruct callers on, procedures, forms, and eligibility in association with MMIS and MN-ITS systems.Minimum Qualifications Two years of customer service experience. Ability to administer policies, procedures, and systems used to make eligibility determinations. Strong computer skills with the ability to navigate multiple software applications, databases, as well as possessing data entry skills. Ability to use math skills using multiple sources of documentation. Strong oral and written communication skills. Ability to read, speak and write English well enough to understand, apply and explain complex eligibility policies. Quickly adapt to changing policies and procedures. Ability to answer phone calls and meet performance and production standards in a high-volume, deadline-driven, and accuracy-focused call center. Ability to multi-task and work independently with a strong work ethic and demonstrated record of regular attendance.Preferred Qualifications
Experience involving decision-making and customer service responsibility within a complex policy environment (e.g. applying eligibility, insurance, health care, or service industry policy while dealing with a high volume customer base).
Experience with the Medical Management Information System (MMIS) payment and eligibility system.
Experience with health care billing.
Experience with electronic data interchange (EDI).
Experience working in a health care call center.
Experience with Minnesota Health Care Programs (MHCP) claims.
Familiarity with medical terminology.
Variety of experiences working effectively with others from different backgrounds and cultures.
Additional RequirementsTo facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.REFERENCE/BACKGROUND CHECKS - The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.AN EQUAL OPPORTUNITY EMPLOYERMinnesota State Colleges and Universities is an Equal Opportunity employer/educator committed to the principles of diversity. We prohibit discrimination against qualified individuals based on their race, sex, color, creed, religion, age, national origin, disability, protected veteran status, marital status, status with regard to public assistance, sexual orientation, gender identity, gender expression, or membership in a local commission as defined by law. As an affirmative action employer, we actively seek and encourage applications from women, minorities, persons with disabilities, and individuals with protected veteran status.Reasonable accommodations will be made to all qualified applicants with disabilities. If you are an individual with a disability who needs assistance or cannot access the online job application system, please contact the job information line at 651-259-3637 or email [email protected] . Please indicate what assistance is needed.