United States of America-OHIO-Franklin County
Lazarus 4 50 West Town Street Columbus 43215
Ohio Department of Medicaid
Bargaining Unit / Exempt:
Jan 22, 2019, 10:59:00 PM
Customer Service Assistant 1 (180006JS)
UNLESS REQUIRED BY LEGISLATION OR UNION CONTRACT, STARTING SALARY WILL BE SET AT STEP 1 OF THE PAY RANGE.
Network Management, Provider Enrollment
Customer Service Assistant (PN 20046406)
The Provider Enrollment unit provides support, technical guidance, and complaint resolution to Ohio Medicaid providers. This position is in a call center which handles inbound calls from Medicaid providers and answers their questions pertaining to a variety of topics including the enrollment process, application status, re-validation, navigating the department's internet web portal, etc. The position is also responsible for applying Medicaid guidelines in reviewing enrollment applications to determine approval and resolving problems or complaints.
Under general supervision, provides assistance &/or information on provider enrollment process for Medicaid program to potential providers (e.g., government officials; Medicaid providers; representatives of provider associations; general public) through written correspondence &/or telephone communication in order to resolve problems, answers questions or resolves complaints involving enrollment of Medicaid providers; provides necessary follow-up to assure consistent maintenance of Medicaid enrollment process; determines appropriate action to resolve identified problems; screens applications & documentation for correctness & completeness regarding Medicaid guidelines for provider enrollment (e.g., required license; accuracy of information entered; correct effective date; category of service; provider type; proper form) & assigns Medicaid numbers; updates provider files &/or records; enters & updates data (e.g., out-of-state status codes; effective dates; certificate numbers; provider number; provider type; ticket number) into database (e.g., Peregrine) system.
Operates personal computer &/or computer terminal to enter, update, correct, delete or send data, retrieve/lookup data, to verify/give out information or give status of file, log & track calls, &/or other information (e.g., movement of file through process) & composes &/or generates reports & correspondence; assists with research to resolve problems & determine solutions; takes appropriate corrective actions (e.g., returns incomplete or incorrect application to applicant for necessary action; re-routes applications sent to wrong address; refers applicant to other areas for assistance [e.g., billing; prior authorization, EFT services, policy, community services, Medicare, Ohio Home Care]); searches current &/or inactive files for data & information (e.g., changes in provider status; name; tax ID numbers linking to group numbers; link up for billing electronically); updates Medicaid Information Technology System (MITS) provider master file (e.g., change of address, group affiliation, category of service).
Prepares & maintains reports concerning work processed/calls handled (e.g, weekly telephone productivity summaries; weekly/daily reports of keyed or returned provider applications); operates photocopier to obtain copies for dissemination &/or for files; operates facsimile equipment to send & receive faxes).
Performs other related duties as assigned (e.g, attends training staff meetings & training sessions; maintains logs, records & files).
3 months training or 3 months experience in office practices & procedures; 1 course or 3 months experience in public relations or customer service to include techniques for dealing with difficult people; 1 course or 3 months experience in typing, keyboarding, data entry or word processing; 1 course or 3 months experience in operation of personal computer.
- Or equivalent of Minimum Qualifications for Employment noted above.
Knowledge of office practices & procedures; public relations; federal &/or state laws, rules, policies &/or procedures applicable to Medicaid provider enrollment*; Medicaid Information Technology System (MITS) for provider enrollment process*. Skill in operation of office equipment (e.g., multi-line telephone, photocopier, facsimile machine); personal computer &/or computer terminal. Ability to apply applicable laws, rules, policies & procedures to respond to Medicaid provider enrollment inquiries, requests &/or complaints &/or process transactions involving several variables within familiar context; handle routine contacts in writing &/or by telephone, e-mail, in-person &/or other means of communication with variety of internal ( e.g., ODM employees) & external customers (e.g., government officials; Medicaid providers; representatives of provider associations &/or general public), some of whom may be irate; collate & classify information about data, people or things; prepare &/or maintain accurate records & reports; work independently on most tasks.
(*) Developed after employment
Attachments to your application are not accepted for this posting. Please be sure to provide detail in the job duty section of your application.
All answers to supplemental questions must be supported by the work experience/education provided on your civil service application.
Unless required by legislation or union contract, starting salary will be set at step 1 of the pay range.
Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.
The final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration.