Jobs for Humanity is partnering with Oklahoma Complete Health to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Oklahoma Complete Health

You have the power to make a difference for our 28 million members. Centene is working towards better health for our communities, one person at a time. As an inclusive national organization, we offer competitive benefits and embrace workplace flexibility.

Oklahoma Complete Health, a Centene company, is dedicated to providing quality healthcare solutions to improve the health of Oklahomans.

At Oklahoma Complete Health, we are advocates for the community and agents of change. We value work-life balance, offer competitive compensation, and support continuous career development. Join us and become part of a collaborative and growing network of innovative thinkers who deliver solutions at the local level.

***Must live in Oklahoma***

Job Position: Ensure accurate setup of providers (individuals, groups, ancillary services, etc.) in the provider information system for state reporting, claims payment, and directories. Responsible for managing multiple state deliverables, network reporting and directories, and resolving claims payment issues related to provider setup.

• Assist external provider representative in resolving provider data issues
• Research and effectively address provider-related inquiries
• Submit provider data entries to update demographic information
• Process provider add, change, and termination forms
• Create and maintain spreadsheets for provider directories
• Track, update, and audit provider data
• Identify changes in key provider groups and model contracts
• Investigate and resolve inaccuracies in claim payments
• Offer support to providers with website registration
• Conduct provider education via webinars
• Collaborate with other departments on cross-functional tasks and projects
• Coordinate new provider orientations and trainings
• Complete assigned special projects

Education/Experience: Preferred qualifications include an associate's degree, experience in claims processing, billing and/or coding, and at least three years of experience in a managed care environment, medical provider office, or customer service within a healthcare organization. Knowledge of healthcare, managed care, Medicare, or Medicaid is desired. Intermediate skills in interpersonal and verbal communication, written communication, organization, time management, prioritization, customer service, representing the company internally, working independently, multitasking, problem-solving, and analytical thinking. Proficiency in Microsoft Excel, Outlook, and Word is required.

Our Comprehensive Benefits Package: We offer flexible work solutions, including remote options and dress flexibility. You will receive competitive pay, paid time off (including holidays), health insurance coverage for you and your dependents, access to 401(k) and stock purchase plans, tuition reimbursement, and best-in-class training and development.

Centene is an equal opportunity employer that values diversity and embraces our differences. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.