Medicaid Customer Service Representative

This is a temporary position and there are no leave or retirement benefits offered with this position. Temporary employees who work an annual average of 30 or more hours per week may be eligible for health insurance coverage under the High Deductible Health Plan (HDHP). For more information on health benefits offered visit www.shpnc.org.

NOTE: If you are a current NC State Government employee, you will be considered for a temporary assignment. However, Temporary Solutionscannot accommodate dual employment.

This temporary position is located in Durham, NC - Durham County. This post is for up to 3 full-time temporary positions.

Telework Availability:

We trust our employees to be self-motivated and successful in hybrid/remote roles; NC Department of Health and Human Services offers work from home options and variable work schedule flexibility for this position.

The Division of Health Benefits requires temporary workers with an approved hybrid telework schedule to work onsite at their assigned duty station at least 8 working days per month. More information on this arrangement may be obtained at the time of the interview.

Hourly Rate: $15.50 to $19.00

(Hourly Rates are based on education, experience, equity, and budget)

Position Overview:

The Administrative Associate II for the Contact Center is designed to perform all required Customer Service Center functions and responsibilities. These functions and responsibilities include: Help Desk, Call Center, PASSR, and N.C. Health Choice for Children programs, Tier I and Tier II. This individual must possess the knowledge, skills, and ability to operate effectively to satisfy a variety of needs for the Customers. This position requires an individual with excellent communication skills, attention to detail and strong strategic thinking abilities.

Job Specific Responsibilities:

• Provide reviews and resolution to Manage Care Medicaid and Direct Medicaid complex issues including Pharmacy, Durable Medical Equipment, Behavior Health, Department of Social Service, Recipient and Providers.
• Monitor expected metrics, targets, and time measurement goals.
• Observe and review data analytics and share information for improvement or accomplishment
• Identify problems and forecast needed changes.

To receive credit for all your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all the following:

• Excellent oral and written communication skills, including the ability to compose clear error free summaries, memos, and letters
• Excellent time management and organizational skills
• Demonstrated skills providing timely and courteous Customer Service in an office environment
• Strong proficiency in Microsoft Office products (Excel, Outlook, PowerPoint, and Word)
• Ability to establish and maintain effective working relationships
• Ability to work independently with minimum supervision

Management Preferences:

• Previous experience working in a call center
• Bilingual (preferably Spanish and English)
• Familiarity with medical terms or medical insurance
• Knowledge of Medicaid and healthcare industry process and procedures

Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details.

High school or General Educational Development (GED) diploma and one year of administrative experience; or an equivalent combination of education and experience.

The North Carolina Department of Health and Human Services (NCDHHS) works closely with beneficiaries, health care professionals, community leaders and advocacy groups; local, state, and federal entities; and other community partners vested to improve the health and safety of all North Carolinians by providing essential human services. NCDHHS is one of the largest, most complex agencies in the state, with about 17,000 employees.

The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid, NC Medicaid Managed Care and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $21 billion in state and federal funds per fiscal year, DHB ensures that more than 96,000 enrolled providers are reimbursed for delivering covered services to 2.9 million beneficiaries.

Realizing the strength of DHB lies in its employees, DHB remains dedicated in its efforts to create and maintain a diverse, equitable and inclusive workplace environment.

Pre-Employment criminal background checks are required for all positions with the Division of Health Benefits (DHB).

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. You will either receive a call to schedule an interview or an email notifying you when the job has been filled.

For technical issues with your application, please call the NeoGov Help Line at 855-524-5627. Applicants will be communicated via email only for updates on the status of their application. If there are any questions about this posting other than your application status, please contact us at Medicaid.Recruitment@dhhs.nc.gov.