Health Care Coverage Representative Job at State of Colorado Job Opportunities – 3.4 Denver, CO

Department Information

Medicaid Operations Office

Client Services Division

Member Contact Center

Must be a Colorado Resident to Apply

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!

**This announcement will remain open until advertised or until 40 applications have been received; whichever occurs first. Eligible applicants are encouraged to apply early.**

We are now hiring representatives to work in the Member Contact Center for the Colorado Department of Health Care Policy & Financing. The Member Contact Center is the main point of contact for Health First Colorado and Child Health Plan Plus (CHP+) members and individuals inquiring about public health insurance.

Information about the Department: In addition to rewarding and meaningful work, we offer a variety of benefits that you simply will not find at other employers:

Public Employees Retirement Account (PERA)


Health/dental insurance options

10 paid holidays

Accrual of paid sick and vacation/annual time

Flex place/work from home

Affordable ECO passes

Fitness center on-site

State of Colorado’s Work-Life Employment Discount Program

Reduced college tuition through CSU Global

Our agency website: Colorado Department of Health Care Policy and Financing

This Department is a “Tobacco Free Workplace”

Description of Job

We are looking for candidates who are passionate about making a difference! This position delivers an exemplary, person-centered customer experience in a high-volume, high-demand contact center for Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+). 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.

We are looking for passionate, hard-working team members who can work well within a structured, contact center environment. 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 issue 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 member’s case while eliciting relevant statements to advise or instruct the member in accordance to 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

Minimum Qualifications

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.


Appropriate experience in a customer-service role related to health care, finance, business administration or a field related to the work assignment that demonstrates problem-solving, analytical skills, and decision making may be substituted on a year-for-year basis for the bachelor’s degree.

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, 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

Required Competencies

Deductive Reasoning: Ability to decipher an individual concern; putting it in context of the member service that is provided. Picking out the key words 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.


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.

If you receive notice that you have been eliminated from consideration for the position, you may protest the action by filing an appeal with the State Personnel Board/State Personnel Director within 10 days from the date you receive notice of the elimination.

Also, if you wish to challenge the selection and comparative analysis process, you may file an appeal with the State Personnel Board/State Personnel Director within 10 days from the receipt of notice or knowledge of the action you are challenging.

Refer to Chapters 4 and 8 of the State Personnel Board Rules and Personnel Director’s Administrative Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel Director’s Administrative Procedures are available at www.colorado.gov/spb.

A standard appeal form is available at: www.colorado.gov/spb. If you appeal, your appeal must be submitted in writing on the official appeal form, signed by you or your representative, and received at the following address within 10 days of your receipt of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director, Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver, CO 80203. Fax: 303-866-5038. Phone:303-866-3300. The ten-day deadline and these appeal procedures also apply to all charges of discrimination.

Supplemental Information

Applicants are encouraged to attach a cover letter and resume to their application.

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 of 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. Be sure your application specifically addresses the requirements as listed in the minimum qualifications. Address your specialized experience, work products, and accomplishments as they relate to the position duties and minimum and preferred qualifications. Attach additional pages if necessary to fully explain your experience and accomplishments. 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:
Structured Application Review:
All applicants who meet the minimum qualifications and Skills Assessment will have their application reviewed through a structured process reviewing for preferred qualifications.

Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of up to 6 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 of this announcement will result in your application being rejected.

Supplemental Questions: Please take your time in reviewing and answering the supplemental questions at the end of the application. Your answers will be reviewed during the Structured Application Review and you will be evaluated on your writing skills in your answers.

Other Supplemental Information:

Technical Help

If you experience difficulty in uploading or attaching documents to your online application, call NEOGOV technical support at 877-204-4442 anytime between 6:00 a.m.-6:00 p.m. (Pacific Time).

ADAAA Accommodations: Any person with a disability as defined by the ADA Amendments Act of 2008 (ADAAA) may be provided a reasonable accommodation upon request to enable the person to complete an employment assessment. To request an accommodation, please contact by phone or email at least five business days before the assessment date to allow us to evaluate your request and prepare for the accommodation. You may be asked to provide additional information, including medical documentation, regarding functional limitations and type of accommodation needed. Please ensure that you have this information available well in advance of the assessment date.

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 Healthcare Policy and 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, Debra Becerra at [email protected] or call 303-866-3887.

We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.

About the Company

Company: State of Colorado Job Opportunities – 3.4

Company Location:  Denver, CO

Estimated Salary:

About State of Colorado Job Opportunities - 3.4