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State of Minnesota - Human Services Dept

Provider Resource Center Representative / MN Health Insurance Program Representative 1

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What they do

A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.

$56,747 / year median in the U.S.

-1% projected decline

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Job Description

Job Details Working Title:
Provider Resource Center Representative Job Class:
Minnesota Health Insurance Programs Representative 1
Agency:
Human Services Dept Job ID :
96340
Location :
St.
Paul Telework Eligible :
Yes Full/Part Time :
Full-Time Regular/Temporary :
Unlimited Who May Apply :
Open to all qualified job seekers
Date Posted :
09/01/2026
Closing Date :
09/10/2026
Hiring Agency/Seniority Unit :
Human Services Dept /
DHS Central Office AFSCME Division/Unit :
DHS-Central Office / HCA
MPPS PR PCC
Physician Work Shift/Work Hours :
Day Shift Days of Work :
Monday•
Friday Travel Required :
No Salary Range:
$24.84
  • $34.84 / hourly; $51,865
  • $72,745 / annually
Classified Status :
Classified Bargaining Unit/Union :
207•
Technical/AFSCME Work Area :
(Required for AFSCME)
FLSA Status :
Nonexempt Designated in Connect 700 Program for Applicants with
Disabilities:
Yes This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework. The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify. The work you'll do is more than just a job. At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities. Job Summary The Provider Resource Center Representative works in a customer service oriented, in-bound call center work environment answering a high volume of calls from health care providers with limited direction from supervisor.
Responsibilities include:
Multi-tasking and analytical skills using multiple computer systems and applications open on the desktop to retrieve information from all sources to complete the call Answering questions from enrolled providers and prospective providers regarding a wide variety of topics including benefits, coverage, claims, authorizations, enrollment and eligibility Analyze, investigate, triage, resolve or assist in the resolution of the callers concerns, highly complex issues or provide additional resources, referrals or support, within given parameters Balance the need to expeditiously service a continuous flow of customers with a focus of ensuring quality service, excellent customer service and relaying accurate, detailed, relevant information Develop and maintain ongoing working relationships with provider groups, their billing practices, medical services/procedures, pharmaceuticals and claims processing cycles Become versed in and able to apply policy, procedures, coding and forms used in association with provider types and transactions Instruct providers on procedures, forms and codes used in association with MMIS and MN-ITS systems Provide step by step procedures with sensitivity to individual learning differences and instruct callers through processes Ability to maintain confidentiality regarding provider information The incumbent must be able to perform the essential functions of the job, with or without reasonable accommodation. Qualifications Minimum Qualifications
  • This posting may be used to fill multiple vacancies
  • To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month, day and year for each job held.
  • Two years of customer service experience One year of experience in a high volume, deadline driven and accuracy-focused call center environment answering phone calls and meeting performance and production standards Ability to administer policies, procedures, and systems used to make eligibility determinations Strong computer skills with the ability to navigate multiple software applications, databases, as well as possessing data entry skills Strong customer service skills and effective oral and written communication Ability to read, speak and write English well enough to understand, apply and explain complex eligibility policies.
Quickly adapt to changing policies and procedures Ability to work within a high volume, deadline-orientated, and accuracy-focused program where performance and production standards must be met Ability to multi-task and work independently with a strong work ethic and demonstrated record of regular attendance Preferred Qualifications Experience involving decision-making and customer service responsibility within a complex policy environment (e.g. applying eligibility, insurance, health care, or service industry policy while dealing with a high volume customer base) Experience with the Medical Management Information System (MMIS) payment and eligibility system Experience with health care billing Experience with electronic data interchange (EDI) Experience working in a health care call center Experience with Minnesota Health Care Programs (MHCP) claims Familiarity with medical terminology Variety of experiences working effectively with others from different backgrounds and/or cultures Additional Requirements To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held. This position requires successful completion of the following: It is the policy of the Department of Human Services that the individual selected for this position successfully complete a background investigation prior to employment, including the following components: Criminal background check Reference check Fingerprinting check (MNJIS/CJIS) Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3 business days from the start of employment; and successfully obtain/retain CJIS certification annually. Application Details How to Apply Select "Apply for Job" at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers. Contact If you have questions about the position, contact Dawn Scott at Dawn.

Scott@state.mn.us. To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to JaKeya Spencer at JaKeya.

Spencer@state.mn.us. If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services' ADA Coordinator at 651-431-4945 or DHS_ADA@state.mn.us for assistance. About Human Services Dept
WE MAKE A DIFFERENCE!
The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential. Working together to improve the state we love. What do Minnesota's State employees have in common? A sense of purpose in their work Connection with their coworkers and communities Opportunities for personal and professional growth Benefits As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.
Your benefits may include:
Paid vacation and sick leave 12 paid holidays each year Low-cost medical, dental, vision, and prescription drug plans Fertility care, including IVF Diabetes care Dental and orthodontic care for adults and children 6 weeks paid leave for parents of newborn or newly adopted children Pension plan that provides income when you retire (after working at least three years) Employer paid life insurance to provide support for your family in the event of death Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury Tax-free expense accounts for health, dental, and dependent care Resources that provide support and promote physical, emotional, social, and financial well-being Support to help you reach your career goals: Training, classes, and professional development Tuition reimbursement Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov) Employee Assistance Program (EAP) for work/life support: A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance Common sources of stress can be addressed through the
EAP:
mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
Daily Living/Convenience Services:
Chore services, home repair, trip planning, child/elder care Programs, resources and benefits eligibility varies based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.
EQUAL OPPORTUNITY EMPLOYERS
Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.
APPLICANTS WITH DISABILITIES
Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.