Provider Resource Center Representative - MN Health Insurance Program Representative 1 Job in St. Paul

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St. Paul, Minnesota (MN)

Employer:	Department of Human Services - Direct Care and Treatment
Job Ref:	75978
Job Type:	Full Time
Location
City:	St. Paul
State:	Minnesota (MN)
Zip Code:	55102
Description
When all employees are embraced, respected and heard, we will build a collaborative, equitable, inclusive and anti-racist culture where everyone thrives. Working Title: Provider Resource Center Representative Job Class: Minnesota Health Insurance Programs Representative 1 Agency: 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 : 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. Job Summary 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. Qualifications 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 Requirements To 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. Application Details How to Apply Select "Apply for Job" at the top of this page. If you have questions about applying for jobs, contact the job information line at 651-259-3637 or email careers@state.mn.us . For additional information about the application process, go to http://www.mn.gov/careers . If you have questions about the position, contact Michelle Prokosch at michelle.prokosch@state.mn.us To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Kelly Ellich at kelly.ellich@state.mn.us . If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services' ADA Coordinator at 651-431-4945 or DHS_ADA@state.mn.us for assistance. About Human Services Dept WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential. Why Work for Us Diverse Workforce We are committed to continually developing a workforce that reflects the diversity of our state and the populations we serve. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve the people of Minnesota. A recent engagement survey of State of Minnesota employees found: 95% of employees understand how their work helps achieve their agency's mission 91% of employees feel trusted to do their jobs 88% of employees feel equipped to look at situations from other cultural perspectives when doing their job 87% of employees report flexibility in their work schedule Comprehensive Benefits Our benefits aim to balance four key elements that make life and work meaningful: health and wellness, financial well-being, professional development, and work/life harmony. As an employee, your benefits may include: Public pension plan Training and professional development Paid vacation and sick leave 12 paid holidays each year Paid parental leave Low-cost medical and dental coverage Prescription drug coverage Vision coverage Wellness programs and resources Employer paid life insurance Short-term and long-term disability Health care spending and savings accounts Dependent care spending account Tax-deferred compensation Employee Assistance Program (EAP) Tuition reimbursement Federal Public Service Student Loan Forgiveness Program Programs, resources and benefits eligibility varies based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota. AN EQUAL OPPORTUNITY EMPLOYER Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. The State of Minnesota recognizes that a diverse workforce is essential and strongly encourages qualified women, minorities, individuals with disabilities, and veterans to apply. We will make reasonable accommodations 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 careers@state.mn.us and indicate what assistance is needed.