Colorado State Health Care Coverage Representative II in Denver Metro, Colorado

Health Care Coverage Representative II



Health Care Coverage Representative II


$2,886.00 - $4,074.00 Monthly


Denver Metro, CO

Job Type

Full Time


Department of Health Care Policy and Financing

Job Number



4/23/2018 11:59 PM Mountain

  • Description

  • Benefits

  • Questions

Department Information

Policy, Communications and Administration 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!

We are now hiring representatives to work in the call center division of the Member Contact Center for the Colorado Department of Health Care Policy & Financing. The Member Contact Center is the Department's main centralized member contact and assistance center for public health insurance inquiries and member specific issue resolution.

Information about the Department:

We are looking for candidates with the skills to be responsive and informative for our clients, and who are passionate about making a difference. 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 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

This position serves to apply established techniques, procedures, practices and methods relevant to the below job description. After successfully completing training and on the job performance in this role, employees may be promoted to Health Care Coverage Specialist III with the potential for a pay increase. This is an entry level, customer service position with opportunities for advancement.

The Health Care Coverage Representative will be responsible for informing and assisting members to access appropriate health care, answering member's questions regarding the services and benefits, and resolving problems a member is experiencing.

We are looking for hard-working team members who are passionate about making an impact on and serving the community. Additionally, team members should work well in a structured environment. The ideal candidate will need to have strong reasoning skills, provide excellent customer service, have the communication skills to guide clients through complex issues, and possess the ability to navigate complexity (e.g., systems, laws). While the Member Contact Center is a high-volume call center environment, inquiries are frequently complex. The combination of speed, efficiency and quality is valued.

Duties are as follows:

  • Provide information to the general public about departmental programs, benefits, rules and policies; additionally, evaluate member issue and draw on available resources to direct members toward community resources and health care options for those uninsured.

  • Actively listens and interprets 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

  • Takes in-bound calls from members pertaining to the State Medicaid Program and other public health insurance programs offered by the State of Colorado (i.e., Colorado Indigent Care Program*)

  • Assist members in navigating a complex health care environment by telephone, internet chat, fax, e-mail or through written correspondence regarding State Medicaid program, Colorado Indigent Care Program, and coordinating programs such as Medicare, CHP+, Connect For Health, etc.

  • Expresses healthcare policies and relevant information clearly and accurately; provides instruction and guides members through various steps or processes. Speaks clearly, responding well to questions. Participates in meetings.

  • Navigate through multiple computer applications as well as the State of Colorado policies, procedures, practices, and methods in order to resolve member inquiries

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Minimum Qualifications:

Two years of experience demonstrating customer service skills or relevant technical knowledge related to health care or public health care. Sample prior work environments may include a call center environment, medical billing experience, etc.


Two years of college, university or non-correspondence school course work related to the work assignment may substitute for one year work experience.

Preferred Qualifications:

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

  • Experience in billing or policy in health care industry; or county 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


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

  2. 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

A standard appeal form is available at: 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

Comparative Analysis Process - Structured Application Review:

The comparative analysis process will consist primarily of a review of applications, cover letters and resumes against the minimum and preferred qualifications of this position.

Comparative Analysis Process - Testing:

Applicants who pass the structured application review will then be asked to complete an exam conducted onsite at the work location. The exam will cover the following competencies:

  • Data Entry

  • Customer Service

  • Critical Thinking

The exam is tentatively scheduled for May 8th to May 11th.

Applications and exams 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.

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).