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Member Contact Center Call Agent

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Member Contact Center Call Agent

Salary

$48,432.00 - $51,096.00 Annually

Location

Denver Metro, CO

Job Type

Full Time

Job Number

UHA04543_07.2025

Department

Department of Health Care Policy and Financing

Division

Medicaid Operations Office

Opening Date

07/22/2025

Closing Date

7/30/2025 11:59 PM Mountain

FLSA

Determined by Position

Type of Announcement

This position is open only to Colorado state residents.

Primary Physical Work Address

303 E 17th Ave Denver, CO 80203

FLSA Status

Non-Exempt; position is eligible for overtime compensation.

Department Contact Information

Jessica Boyer, Talent Acquisition Specialist ~ [email protected]

How To Apply

Please submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.

+ Description

+ Benefits

+ Questions

Department Information

STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

NOTE: This announcement may be used to fill multiple openings.

Are you interested in becoming informed and applying your knowledge to a topical challenge such as Health Insurance? Are you looking to make a difference in people's lives in your community? Do you care about providing a quality member experience?

If you said "yes" to any of the above questions – we have an opportunity available for you. Join the Colorado Department of Health Care Policy & Financing!

We are now hiring Member Contact Center Call Agents to work in the Member Contact Center for the Colorado Department of Health Care Policy & Financing. The contact center is the Department’s main point of contact with assistance to public health insurance inquiries and customer specific issue resolution. The center delivers direct services to the 1.6 million members enrolled in Health First Colorado, which offers 26 different benefit plans.

Based on performance in this role, t here is a well-developed path for advancement.

The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health programs for qualified Coloradans. Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.

As part of the State of Colorado, HCPF offers a competitive benefits package: (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits)

+ PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans

+ Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/medical-benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and Vision (https://dhr.colorado.gov/state-employees/state-employee-benefits/vision-insurance) insurance coverage

+ Automatic Short-Term and Optional Long-Term Disability Coverage (https://dhr.colorado.gov/state-employees/state-employee-benefits/disability-insurance)

+ Life and AD&D Insurance

+ Flexible Spending Accounts (https://dhr.colorado.gov/state-employees/state-employee-benefits/flexible-spending-accounts) (FSAs)

+ Family Medical Leave Act (FMLA) (https://dhr.colorado.gov/state-employees/time-off-leave/family-medical-leave-act-fmla) job protection and State of Colorado Paid Family Medical Leave (PFML)

+ 11 Paid Holidays Annually and Accrued Annual and Sick Leave (https://dhr.colorado.gov/state-employees/time-off-leave)

+ Accrued Sick Leave for State of Colorado Temporary Employees

+ Flexplace and Flextime work arrangements

+ Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program

+ Free RTD EcoPass (https://www.rtd-denver.com/fares-passes/ecopass) to all eligible State Employees

+ Credit Union of Colorado (https://www.cuofco.org/credit-union-colorado-membership-eligibility) Membership Eligibility

+ Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs

We are onboarding new employees using a hybrid approach. The Department supports flexible work arrangements. Depending on the business need and description of the position, we have options that range from hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage.

NOTE:In the event of technical issues (rendering an agent unable to work remotely), we require the agent to report to the Denver office for their shift, to avoid negatively impacting center operations and our ability to answer incoming calls effectively.

Description of Job

Description of Job

We are looking for passionate, hard-working team members who can work well within a structured, high-volume, high-demand contact center environment. This position provides first contact resolution, solves members problems, resolves billing issues, answers complex benefit questions and helps members find providers using person-centered principles. This is an entry level position.

The ideal candidate will:

+ have extremely reliable and predictable attendance,

+ have the ability to sit in front of a PC/monitor, fielding phone, chat and emails using multiple systems for extended periods of time,

+ have exceptional listening, questioning and troubleshooting skills,

+ have strong typing skills,

+ have strong reasoning skills,

+ provide excellent customer service,

+ be able to simplify complex concepts and issues,

+ have excellent written and verbal communication skills,

+ navigate complex benefits, programs and IT systems,

+ have strong time management and multi-tasking skills, and

+ have a high level of self-motivation and ethical self-management

Duties are as follows:

+ Assess member's needs and provide expert service and the best solution to their problem, minimizing the member's effort.

+ Provide accurate information for over 26 different benefit programs, benefits, rules and policies; additionally, evaluate member issues and draw on available resources to direct members toward appropriate resources, which may be in the community or options for those uninsured.

+ Actively listen and interpret the member's case while eliciting relevant statements to advise or instruct the member in accordance with our Member Contact Center standard protocol regarding eligibility, benefits and health care alternatives.

+ Take in-bound calls from members pertaining to all public health insurance programs offered by the Department (including but not limited to: Colorado Indigent Care Program (CICP), Health First Colorado, CHP+)

+ Assist members in navigating a complex health care environment by telephone, internet chat, fax, e-mail or through written correspondence regarding all public health insurance programs offered by the Department.

+ Communicate healthcare benefits, qualifications, policies and relevant information clearly and accurately; provide instruction and guide members through various steps or processes. Speak clearly, responding well to questions. Participate in team meetings.

+ Navigate through multiple computer applications as well as the Department reference materials, policies, procedures, practices, and methods in order to resolve member inquiries.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Residency Requirement:

This posting is only open to residents of the State of Colorado at the time of submitting your application.

Class Code & Classification Description:

H1B1XXADMINISTRATOR I (https://drive.google.com/file/d/0B4enHpLSVk4eWkZaX3pITkthalE/view?usp=sharing&resourcekey=0-7JnyseeYiyxZjlARRHfAZg)

MINIMUM QUALIFICATIONS:

There are two ways to qualify for this position:

Option 1:

Experience Only:

Four (4) years in a customer service role related to health insurance, health care operations, insurance claims and billing, collections, or a field related to the work assignment that demonstrates problem-solving, analytical skills, and decision-making.

OR

Option 2:

Education and Experience:

Bachelor's degree from an accredited institution in Health & Human Services, Health Policy and Administration, Business Administration, Communications, Humanities, Social Work or a field of study related to the work assignment.

OR

A combination of related education and related professional experience (as described above), equal to four (4) years.

You MUST submit a copy of your transcripts with your application materials if you are using the bachelor's degree to meet the minimum qualifications.

PREFERRED QUALIFICATIONS

+ Bilingual in Spanish, Russian, Cantonese, Hmong, Farsi or Vietnamese – other languages will be considered

+ Experience in finance, billing, administration or policy in health care industry

+ Health First Colorado or County Human Services eligibility experience

+ Prior State of Colorado experience related to the duties of this position

Required Competencies

+ Deductive Reasoning: Ability to decipher an individual concern; putting it in context of the member service that is provided. Picking out the keywords of what the issue is through active listening. Having a solution-orientated response to apply healthcare policies to specific client questions and problems to provide accurate answers.

+ Customer Service and Communication Skills: Demonstrates a commitment to excellent member service, providing internal customers and external members with accurate information or assistance in resolving problems with kindness and compassion demonstrated through active listening, comprehension, patience and composure. Excellent phone skills. Expresses information and ideas clearly and accurately; provides instructions that are clear and easy to follow.

+ Instruction Skills: Ability to assimilate information and communicate it to others.

+ Technical Skills: This position requires strong computer and typing skills for in-role documentation and the ability to demonstrate technical agility and resourcefulness through navigating through multiple complex systems (CRM, Eligibility System, Billing System, Pharmacy System, IVR, etc.).

+ Diplomacy: Uses discretion and tact when interacting with external clients; effectively handles tense situations over the phone; attentively listens to external clients, taking time to understand the points being made; demonstrates patience and understanding in a time of crisis.

Preferred Competencies

+ Adaptability: Adapts quickly to change and is able to handle multiple client problems and navigate through resources in a calm, organized manner; is open to new ideas and methods.

+ Critical Thinking:Uses logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to member's cases.

+ Service Orientation: Actively looking for ways to help serve members that contact the Member Contact Center.

DEFINITION OF PROFESSIONAL EXPERIENCE: Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods.

CONDITIONS OF EMPLOYMENT:

+ All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.

+ Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.

+ Satisfactory completion of a language proficiency test is required to receive any bilingual pay differential (if applicable).

Appeal Rights:

An applicant who has been removed from an employment list or removed from consideration during the selection process may request a review by the State Personnel Director.

As an applicant directly affected by the results of the selection or comparative analysis process, you may file a written appeal with the State Personnel Director.

Review of the completed, signed and submitted appeal will be timely on the basis of written material submitted by you, using the official appeal form signed by you or your representative. This form must be completed and delivered to the State Personnel Board by email at [email protected] within ten (10) calendar days from your receipt of notice or acknowledgement of the Department’s action.

For further information on the Board Rules, you can refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules .

Supplemental Information

How to Apply (https://careers.colorado.gov/how-to-apply) (PLEASE READ CAREFULLY)

Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked "SEE RESUME" will not be considered.

Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.

Comparative Analysis Process

The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email.

Failure to submit properly completed documents by the closing date will result in your application being rejected.

ADAAA Accommodations : The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Virginia Miller, at [email protected] .

The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.

The State of Colorado offers permanent employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for detailed information: www.colorado.gov/pacific/dhr/benefits

Please note that each agency's contact information is different; therefore, we encourage all applicants to view the full, official job announcement which includes contact information and class title. Select the job you wish to view, then click on the "Print" icon.

01

All HCPF positions are security-sensitive positions and require potential employees to undergo a criminal record background check. As a condition of employment, you will be required to submit to pre-employment screening if offered the position. Are you willing to meet this requirement?

+ Yes

+ No

02

Do you have any relatives or significant others working at the Department of Health Care Policy & Financing? If so, please list their names here. Otherwise, please list N/A.

03

Per the requirements of the Step Pay Program implemented on July 1, 2024, any State employee must be paid a rate that is equal to or greater than the appropriate step pay rate within their classification’s pay range based on completed years in their current class series as of June 30. All current and former State employees must ensure that your entire work history within the State Classified System, including at Institutions of Higher Education, is indicated in your application so that your time-in-series can be calculated accurately. Please verify that this information is included in your application in the supplemental questions

+ Yes

+ No

04

Are you willing to accept an offer within the posted salary range?

+ Yes

+ No

05

Former state employees who were disciplinarily terminated or resigned in lieu of termination must disclose the information on the application. In the space below, please provide an explanation as to why the prior termination or resignation should NOT disqualify your application from the current position. Otherwise, please list N/A.

06

Please explain how your degree and experience is related to the work assignment.

07

Describe a problem that you had to solve in the workplace. What was your process in solving this problem?

08

If available, I would like to be considered for bilingual vacancies (positions requiring proficiency in speaking and/or writing a language in addition to English). Satisfactory completion of a language proficiency test is required to receive any bilingual pay differential.

+ Yes

+ No

09

List any additional relevant experience you would like us to consider in determining if you meet the qualifications of this position. Please, include the months and years relevant to the experience you describe.

Required Question

Employer

State of Colorado

Address

See the full announcement by clicking

the "Printer" icon located above the job title

Location varies by announcement, Colorado, --

Website

https://careers.colorado.gov/

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