Former Employee Enrollment Specialist

Recruitment #210329-UNCA-04

Introduction

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

The Office of Management and Enterprise Services (OMES) is dedicated to providing excellent service, expert guidance, and continuous improvement in support of our partners’ goals. We are a highly-qualified workforce committed to serve those who serve Oklahomans and make government run in the most efficient, innovative manner possible. Achieving this mission takes a collaborative, agile, respectful team with humble leaders who make a difference and get things done. 

For more information about OMES, please visit our website.  

OMES is seeking a full time Former Employee Enrollment Specialist with Employees Group Insurance Division (EGID). 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 $42,850.00 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.

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.

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

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.