|Department||Health Care Authority|
|Date Opened||11/5/2019 08:00:00 AM|
|Filing Deadline||11/19/2019 11:59:00 PM|
|Full or Part Time||
Insure Oklahoma Program Coordinator II
Under the direction of the Insure Oklahoma Manager this position: determines employee and employer eligibility; enrolls employee and employers; and researches and resolves member and employer issues related to the Insure Oklahoma program in a timely manner. This position will work with Insure OK members, independent insurance agents, employers, and other stakeholders to research and resolve issues related to the program, individual eligibility, employer eligibility, premium payments, etc., in a timely manner.
*Answers incoming telephone inquiries from employees, employers, insurance agents and providers. Requires individual research and interpretation of federal rules and procedures and agency rules in relation to the Insure OK program
*Researches, analyzes, and resolves employee and employer issues related to the Insure OK program as identified in inquiries, access to care issues, complaints, e-mail, written correspondence, and telephone calls. Initiates action necessary to resolve issues which encompasses outbound calling
*Determines eligibility, verifies and enters data. Researches and resolves any problems relating to enrollment and premium payments. Identifies potential operational and contractual issues and participates in the formulation of procedures to resolve conflicts or provide clarification
*Processes enrollment, plan changes and corrections to member enrollment data system
*Attends meetings with agency personnel and other officials. Represents OHCA as needed in seminars and training forums
*Facilitates claims adjudication/capitation/reconciliation
*Assists in maintaining work flow during staff absences
*Identifies individual employer and/or agent training needs
*Acts as back up as need in other areas
*Other duties as assigned
IO PROGRAM COORDINATOR II EDUCATION AND EXPERIENCE:
*An Associate’s degree AND Eighteen (18) months of experience in Insure Oklahoma, SoonerCare or call center; OR an equivalent combination of education and experience totaling 3 ½ years.
PREFERENCE MAY BE GIVEN TO CANDIDATES WITH:
*Direct experience with Insure Oklahoma.
Veteran’s preference points apply only for initial appointment in the classified service.