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The Provider Contracting Specialist manages provider contracts, maintains accurate provider data, and ensures compliance with regulatory policies. This role involves fostering strong provider relationships and resolving inquiries to support effective network operations.
Requirements
Candidates must have a bachelor's degree and at least 2 years of experience in health insurance benefit administration or provider contracting. Strong knowledge of reimbursement methodologies, claims processes, and regulatory requirements is essential for this role.
Full job description
Job Posting Title
Provider Contracting Specialist
Agency
807 HEALTH CARE AUTHORITY
Supervisory Organization
EGID
Job Posting End Date
Refer to the date listed at the top of this posting, if available. Continuous if date is blank.
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Estimated Appointment End Date (Continuous if Blank)
Full/Part-Time
Full time
Job Type
Regular
Compensation
$22.81875 / Hourly
Why You’ll Love Working Here
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. Learn more about OHCA.
Let’s Talk Benefits
We know your great work deserves great support. Here’s a snapshot of what we offer for all eligible employees.
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 / 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,empowermentand accountability, best in class and outcome-driven, and servant leadership.As part of the interview process, candidates maybe requiredto attend an in-person interview at our Oklahoma City office.
Position Purpose
The Provider Contracting Specialist is responsible for managing providercontracts, maintaining provider relationships, and ensuring compliance with applicableregulations and policies. This role includes handling incoming and outgoingcommunications, maintainingaccurate provider data, and supporting provider networkmanagement activities to ensure efficient and effective service delivery.
Essential FunctionsMay Include:
Ensure accurate and timely management of provider contracts, including pricing NSA claims, negotiating NSA requests, and responding to independent dispute resolutions.
Foster strong working relationships with providers through effective communication, timely response to inquiries, and proactive resolution of issues.
Adhere to HIPAA regulations, OMES policies, and other relevant statutes by protecting the privacy and confidentiality of program participants' information.
Enter and review provider demographics accurately and timely, ensuring an accuracy rate of 97% or better based on audits.
Handle incoming and outgoing calls, emails, and provider retention tasks while maintaining a customer service quality audit score of 85% or better.
Other duties as assigned.
Knowledge,Skills,/Abilities and Competency Requirements
This position requires knowledge of provider contracting, health insurance operations, reimbursement methodologies, claims processes, regulatory requirements, and provider database maintenance. The successful candidate mustdemonstratestrong organizational, analytical, customer service, written and verbal communication, negotiation, and problem-solving skills, with the ability to manage multiple priorities,maintainaccurateand confidential information, interpret contract provisions and policies, and build effective relationships with providers and internal partners. Key Korn Ferry competencies include Ensures Accountability, by consistently meeting accuracy, quality, and timeliness standards; Communicates Effectively, by providing clear, responsive, and professional communication; and Manages Complexity, by evaluating detailed contractual, regulatory, reimbursement, and provider-related information to resolve issues and support effective network operations
To be considered for this position your application must include a resume/CV with complete work and education history.
Education and/or Experience:
A bachelor’s degree and 2 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 Medicare guidelines policies and procedures.
Knowledge of provider licensing, certification, contractual issues, reimbursement, procedural coding, benefit coverage and liability requirements. Knowledge regarding these laws, regulations and proceduresarecritical to the management of an effective Provider Network.
Knowledge of provider database maintenance, plan provisions, agency policies, provider types, credentials management, coding and reimbursement methods, claims payment process, and contract provisions/terminology.
Strong organizational skills.
Knowledge of large group network management and provider services to include provider enrollment and contracting, verbal and written communication skills, customer services and experience providing phone coverage, provider recruitment, training, response to member and provider inquiries, use of network database applications
Requires a detailed understanding of insurance plan provisions, terms, policies,provider types, credentials management, coding and reimbursement methods, claims payment processes, contract provisions and terminology.
Knowledge of and ability to use Microsoft Office Applications.
Physical Demands andWork Environment
Work is typically performed in an office setting with climate-controlled settings and exposure tomoderate noise levels.In the course ofperforming job duties, employeesare required tospeak, 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 this position.
Accommodation Statement
The Oklahoma Health Care Authoritycomplies withapplicable 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. Ifa reasonableaccommodation is needed toparticipatein 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 Jobs Hub.
Equal Opportunity Employment
The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.
Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.
If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information:
The Oklahoma State Department of Health, through its system of local health services delivery, is ultimately responsible for protecting and improving the public's health status through strategies that focus on preventing disease. Four major service branches, Community and Family Health Services, Wellness Programs, Disease, Prevention and Preparedness Services and Protective Health Services, provide technical support and guidance to 68 county health departments as well as guidance and consultation to the two independent city-county health departments in Oklahoma City and Tulsa.
Offices: 1000 NE 10th St, Oklahoma City, Oklahoma 73117, US · 100 S Rock Island Ave, El Reno, Oklahoma 73036, US
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How many Finance & Accounting jobs are open in Oklahoma City, OK right now?
There are currently 671 open finance & accounting positions in Oklahoma City, OK listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Oklahoma City, OK?
Companies currently hiring include 1st Century Bank, Oklahoma State Department of Health, Love's Travel Stops, BOK Financial, Center for English as a Second Language at the University of Oklahoma, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Oklahoma City, OK?
Yes — 121 of the 671 open finance & accounting positions offer remote or hybrid work (50 remote, 71 hybrid).
How do I apply for Finance & Accounting jobs in Oklahoma City, OK?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.