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Provider Contracting Specialist

Recruitment #121213-UNCA-25

Introduction

A resume and cover letter must be submitted along with your application.

The Office of Management and Enterprise Services (OMES) is a government agency providing services to other Oklahoma government agencies. We work toward the goals of capitalizing on available resources, continuing to seek cost saving opportunities and elevating our level of service. Our mission is to be a “FAST” agency: Flatter, Agile, Streamlined, and Technology-enabled.

The Office of Management and Enterprise Services - Employees Group Insurance Division is seeking a full time Provider Contracting Specialist for our Oklahoma City location. This is an Unclassified, position within Oklahoma State Government.  In addition to a generous  Benefits Packet the annual salary for this position is up to $34,307.04 based on education and experience. 

The individual in this position will serve as a liaison between the Employees Group Insurance Division, the third party claims administrator and network providers.  The position is responsible for developing and maintaining comprehensive provider networks through provider recruitment, contracting, and retention.


Principal Responsibilities: 
• Network Management and recruiting for Health & Dental networks for HealthChoice, Dept. of Corrections and Dept. of Rehabilitation Services.
• Credentials management including maintenance of provider databases, contracts, and credentialing applications.
• Provider and staff education related to health & dental contracts, benefits, claims submission, coding, adjudication and reimbursement.
• Assist with creation of provider education material, newsletters and articles for publication.
• Review and resolve providers contracting and claim issues.
• Work with other agency and TPA staff to obtain goals and objectives of agency including, grievances, plan benefit changes, system updates and testing etc.
• Represent the agency in provider seminars, conferences and meetings.

OMES is an Equal Opportunity Employer. Reasonable accommodation to individuals with disabilities may be provided upon request

Conclusion

Veteran’s preference points apply only for initial appointment in the classified service.



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