EGID Provider Relations Specialist
Thunderbird, Oklahoma City, Oklahoma, United States, 73116
At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values, **Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership**, we foster a workplace where people feel supported, respected, and empowered to make an impact. * Generous state-paid
to offset insurance premiums.* A wide selection of
with no pre-existing condition exclusions.* for health care and dependent care.* with employer contributions.* 11 paid holidays annually.* 15 days of vacation and 15 days of sick leave in the first year.* Longevity Bonus recognizing years of public service.* Public Service Loan Forgiveness eligibility and tuition reimbursement.* Wellness benefits, including an on-site gym and fitness center discounts.**Job Description****Location:** 4345 N Lincoln Blvd, Oklahoma City, OK 73105**Salary:** $22.81875 per hour**Work Schedule:** Monday – Friday**Primary Hours:** 8:00 a.m. – 5:00 p.m.# # **Agency/Division Information**The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. **Position Purpose** provider communications and directories, reimbursement, escalations, ensuring compliance with various regulations and rules, and providing exceptional customer service through effective communication and problem-solving skills. This role is essential in # # **Knowledge, Skills, Abilities and Competency Requirements**The Provider Relations Specialist role requires strong analytical and communication skills to manage provider communications, maintain accurate directories, and respond to provider inquiries with a high level of customer service. The position demands knowledge of healthcare reimbursement practices, claims processing, insurance regulations, and benefit plan administration. Proficiency in Microsoft Office, particularly Excel and SharePoint, and familiarity with health care terminology and compliance requirements are essential. Success in this role hinges on the ability to interpret complex regulations, manage detailed data sets, and support cross-functional initiatives. The three Korn Ferry competencies most relevant to this position are Ensures Accountability (for maintaining accurate and timely provider data and reports), Customer Focus (for effectively responding to provider needs), and Optimizes Work Processes (for streamlining communication and directory updates in compliance with regulatory requirements). **\*\*To be considered for this position your application must include a resume/CV with complete work and education history.\*\***# **Education and/or Experience:*** Abachelor’s degree and2 years of experience in health insurance benefit administration or health care industry provider contractingOR* An equivalent combination of education and experience.# **Preference Qualifications Include:*** Knowledge of Microsoft Office with a fundamental knowledge of Excel functions, Visual Basic for Applications (VBA) and working with large data sets in various applications.* Knowledge of state and federal laws and regulations pertaining to various types of health and dental benefit plans and federally mandated programs, including CMS-Medicare guidelines.* Knowledge of medical and dental markets, insurance & contracting terminology, practices, and process controls.* Knowledge of Medicare and commercial reimbursement methodologies and related coding systems.* Knowledge of claims processing systems and guidelines.* Knowledge of and experience with the No Surprises Act.* Knowledge of insurance plan related administrative procedures.# **Physical Demands and Work Environment**Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of the job.# **Accommodation Statement:**The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate.
All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.**Notice to applicants:**Please add OHCAHR@okhca.org
to the address book or “safe-senders” list in your email.
All correspondence will come from this address.
Be sure to check your junk folder.
If you have questions about the status of your application, you can contact the HR team at 405-522-7093.**Note:** Applications will be accepted until 11:59 PM on the day prior to the posting end date above.**Current State of Oklahoma employees** must apply for open positions internally through Workday .Other duties as assigned. #J-18808-Ljbffr
to offset insurance premiums.* A wide selection of
with no pre-existing condition exclusions.* for health care and dependent care.* with employer contributions.* 11 paid holidays annually.* 15 days of vacation and 15 days of sick leave in the first year.* Longevity Bonus recognizing years of public service.* Public Service Loan Forgiveness eligibility and tuition reimbursement.* Wellness benefits, including an on-site gym and fitness center discounts.**Job Description****Location:** 4345 N Lincoln Blvd, Oklahoma City, OK 73105**Salary:** $22.81875 per hour**Work Schedule:** Monday – Friday**Primary Hours:** 8:00 a.m. – 5:00 p.m.# # **Agency/Division Information**The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. **Position Purpose** provider communications and directories, reimbursement, escalations, ensuring compliance with various regulations and rules, and providing exceptional customer service through effective communication and problem-solving skills. This role is essential in # # **Knowledge, Skills, Abilities and Competency Requirements**The Provider Relations Specialist role requires strong analytical and communication skills to manage provider communications, maintain accurate directories, and respond to provider inquiries with a high level of customer service. The position demands knowledge of healthcare reimbursement practices, claims processing, insurance regulations, and benefit plan administration. Proficiency in Microsoft Office, particularly Excel and SharePoint, and familiarity with health care terminology and compliance requirements are essential. Success in this role hinges on the ability to interpret complex regulations, manage detailed data sets, and support cross-functional initiatives. The three Korn Ferry competencies most relevant to this position are Ensures Accountability (for maintaining accurate and timely provider data and reports), Customer Focus (for effectively responding to provider needs), and Optimizes Work Processes (for streamlining communication and directory updates in compliance with regulatory requirements). **\*\*To be considered for this position your application must include a resume/CV with complete work and education history.\*\***# **Education and/or Experience:*** Abachelor’s degree and2 years of experience in health insurance benefit administration or health care industry provider contractingOR* An equivalent combination of education and experience.# **Preference Qualifications Include:*** Knowledge of Microsoft Office with a fundamental knowledge of Excel functions, Visual Basic for Applications (VBA) and working with large data sets in various applications.* Knowledge of state and federal laws and regulations pertaining to various types of health and dental benefit plans and federally mandated programs, including CMS-Medicare guidelines.* Knowledge of medical and dental markets, insurance & contracting terminology, practices, and process controls.* Knowledge of Medicare and commercial reimbursement methodologies and related coding systems.* Knowledge of claims processing systems and guidelines.* Knowledge of and experience with the No Surprises Act.* Knowledge of insurance plan related administrative procedures.# **Physical Demands and Work Environment**Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of the job.# **Accommodation Statement:**The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate.
All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.**Notice to applicants:**Please add OHCAHR@okhca.org
to the address book or “safe-senders” list in your email.
All correspondence will come from this address.
Be sure to check your junk folder.
If you have questions about the status of your application, you can contact the HR team at 405-522-7093.**Note:** Applications will be accepted until 11:59 PM on the day prior to the posting end date above.**Current State of Oklahoma employees** must apply for open positions internally through Workday .Other duties as assigned. #J-18808-Ljbffr