Provider Resource Center Representative - MN Health Insurance Program Representative 1

When all employees are embraced, respected and heard, we will build a collaborative, equitable, inclusive and anti-racist culture where everyone thrives.

Job Details

Working Title: Provider Resource Center Representative
Job Class: Minnesota Health Insurance Programs Representative 1
Agency: Human Services Dept

• Job ID: 80657
• Location: St. Paul
• Telework Eligible: Yes
• Full/Part Time: Full-Time
• Regular/Temporary: Unlimited
• Who May Apply: Open to all qualified job seekers
• Date Posted: 10/02/2024
• Closing Date: 10/11/2024
• Hiring Agency/Seniority Unit: Human Services Dept / DHS Central Office AFSCME
• Division/Unit: Health Care Administration / Medicaid Provider and Payment Services
• Work Shift/Work Hours: Day Shift / 8:00am - 4:30pm
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $23.26 - $32.79 / hourly; $48,566 - $68,465 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 207 - Technical/AFSCME
• Work Area: G - Member and Provider Services
• FLSA Status: Nonexempt
• 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. DHS does not participate in E-Verify.

The work you'll do is more than just a job.

At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.

Job Summary

***This posting may be used to fill multiple openings***

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.
• One year of experience in a high volume, deadline driven and accuracy-focused call center environment answering phone calls and meeting performance and production standards
• Must be able to administer policies, procedures, and systems used to make eligibility determinations.
• Must be able to navigate multiple software applications, databases, as well as possessing data entry skills.
• Strong math skills using multiple sources of documentation.
• Strong oral and written communication skills.
• Must be able to read, speak and write English well enough to understand, apply and explain complex eligibility policies.
• Quickly adapt to changing policies and procedures.
• Strong multi-tasking skills
• Must be able to work independently with a strong work ethic and demonstrated record of regular attendance.

Preferred Qualifications

• 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.
• E xperience 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 Careers Help Desk at 651-259-3637 or email careers@state.mn.us . For additional information about the application process, go to http://www.mn.gov/careers .

Contact

If you have questions about this position, contact Kalia Yang at kalia.yang@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.

Working together to improve the state we love.

What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

Benefits

As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include:

• Paid vacation and sick leave
• 12 paid holidays each year
• Low-cost medical, dental, vision, and prescription drug plans
  • Fertility care, including IVF
  • Diabetes care
  • Dental and orthodontic care for adults and children
• 6 weeks paid leave for parents of newborn or newly adopted children
• Pension plan that provides income when you retire (after working at least three years)
• Employer paid life insurance to provide support for your family in the event of death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals:

• Training, classes, and professional development
• Tuition reimbursement
• Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov )

Employee Assistance Program (EAP) for work/life support:

• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

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.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

APPLICANTS WITH DISABILITIES

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.