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Former Employee Enrollment Specialist

Recruitment #200203-UNCA-03

Introduction

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

The Office of Management and Enterprise Services (OMES) is a trusted, credible partner that empowers employees to provide valued business expertise allowing customers to focus on their missions across state government. OMES provides financial, property, purchasing, human resources and information technology services to all state agencies, and assists the Governor’s Office on budgetary policy matters.

Our mission is supporting our partners through unified business services.  The OMES mission requires a highly-qualified workforce committed to making government run in the most efficient, innovative manner possible. Achieving that mission takes team-oriented, solutions-driven professionals who understand the importance of partnering to achieve success.

OMES is seeking a full time Former Employee Enrollment Specialist. This is an unclassified position in state government, located in Oklahoma City. OMES offers a comprehensive Benefits Package, including a generous benefit allowance to offset the cost of insurance premiums for employees and their eligible dependents.  For more information about the benefit allowance [click here].The annual salary for this position is up to $42,850, based on education and experience.

Position Summary
This position is assigned responsibilities involving specialized accounting work related to the enrollment and maintenance of member accounts to reflect changes received from retirees, survivors, and Cobra members separating from a state agency, local government or school.  Responsibilities may include data entry and reviewing, analyzing, recording and reconciling Medicare reports, queries, projects and responding to inquiries concerning policies and procedures.

Position Responsibilities/Essential Functions
• Process Enrollment Forms, Change Forms, Termination Forms and other assigned correspondence within accuracy ranges, adhering to all unit procedures and EGID rules and regulations.
• Correctly recognize and reject non-compliant forms within accuracy ranges, in compliance with current Center for Medicare & Medicaid Services (CMS) Part D Program (PDP) Guidance, EGID rules and regulations and all unit procedures.
• Process Transaction Reply Reports and Low Income Subsidy Reports within the accuracy ranges, in compliance with current CMS PDP Guidance, EGID rules and regulations and all unit procedures.
• Process recurring small reports (Weekly MAPD reports) within accuracy ranges, in compliance with current CMS PDP Guidance, EGID rules and regulations and all unit procedures.
• Process recurring large reports (CVS Monthly Subsidy Report and CVS Reject Report) within accuracy ranges, in compliance with current CMS PDP Guidance, EGID rules and regulations and all unit procedures.
• Process special projects within the accuracy ranges, in compliance with current CMS PDP Guidance, EGID rules and regulations and all unit procedures.
• Reviews and analyzes discrepancy reports received for various types of insurance or benefits, such as health, dental, life and vision insurance.
• Process and distribute incoming and/or returned mail, forms and correspondence for Member Accounts.
• Understands and adheres to HIPAA Compliance and Fraud, Waste and Abuse policies and successfully complete annual trainings for compliance.
• CMS required notifications:  Complete and mail proper CMS required notifications for all enrollments, dis-enrollments, cancellations or changes associated with Medicare Part D within the accuracy ranges, adhering to all unit procedures and EGID rules and regulations.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Valued Skills and Experience
• Ability to establish and maintain effective working relationships with others.
• Ability to communicate effectively, both orally and in writing.
• Ability to exercise good judgment in analyzing situations and making decisions.

Physical Demands and Work Environment
This position works in a comfortable office setting with a large percentage of the work day done on a computer and telephone.  The noise level is usually mild.  Ability to occasionally lift paper and office supplies and to perform job duties on a computer and telephone for 6-8 hours per day is necessary.  Occasional travel may be required.

 

MINIMUM QUALIFICATIONS

A bachelor’s degree; or two years of experience in bookkeeping work, insurance eligibility determination or closely related work; or two years of experience in the maintenance, analysis and reconciliation of insurance or benefits accounts; or an equivalent combination of education and experience.

NOTES

Please read instructions carefully and include all required documents when you submit your application.

No additional information will be accepted after the application has been submitted.

Conclusion

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



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