Full-time

Job Posting Title

Call Center Specialist

Agency

090 OFFICE OF MANAGEMENT AND ENTERPRISE SERV

Supervisory Organization

EGID - Member Services

Job Posting End Date (Continuous if Blank)

July 06, 2023

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

Up to $46,000.00 based on education and experience

Job Description

As a Call Center Specialist with OMES you will enjoy :

  • Generous leave including 15 days of vacation, 15 days of sick leave and 11 paid holidays annually.
  • A comprehensive with a generous to offset the cost of insurance premiums for employees and their eligible dependents.

Job Details

  • Full-time 40-hour work weeks.
  • Support the Employee Group Insurance Division
  • Salary up to : $46,000.00

Responsibilities

  • Answer calls in the call center loop from members, providers and insurance coordinators, interpreting the plans processes related to eligibility, enrollment, change, termination, retirement and COBRA by providing oral responses to queue generated calls or direct calls to active members, dependents, retired members, and survivors based on knowledge of rules, regulations, statutes and understand details of Centers of Medicare and Medicaid Services (CMS) guidelines as a contracted CMS provider as well as work processes or procedures that may apply.
  • Execute or respond to all paper, email or RightNow system communication in a timely manner, whether communication is from a member, supervisor, manager, peer or other source.
  • Maintain a complete and accurate log of each call taken or placed, each fax received or sent, and each email or paper correspondence received or assigned by Management.
  • Assist members by coordinating with other departments in claim, pharmacy, eligibility, premium billing or payment and / or policy issue resolution by researching and working in partnership with departments to resolve benefit concerns and ensure member satisfaction.
  • Troubleshoot health, dental benefits or pharmacy purchase denials or Prior Authorizations when an issue arises for member, provider, or pharmacy.
  • Assist in training new employees on all Call Center activity and materials when needed and provide immediate guidance to peers in response to call inquiries.
  • Review articles, manuals, publications for improving various public information / communications as well as the HealthChoice website to guide the caller or member to various resources, troubleshoot password issues and contribute to web content based on reported member call trends.
  • HIPAA Compliance - Must safeguard all Personal Health Information (PHI) by making sure work area is HIPAA compliant and all work stations are secure while away.

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.

Minimum Qualifications

  • A bachelor’s degree in business administration, public health administration or a related field or;
  • Four (4) years of experience in health, dental, life and disability customer service environment or;
  • An equivalent combination of education and experience.

About

The Office of Management and Enterprise Services provides 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.

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

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 State of Oklahoma employees must apply for open positions through their Workday account. Go to Careers app on WD home screen>

Click on 'Find Jobs-Internal State of Oklahoma'.

Apply Now

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Job Posting Title

Call Center Specialist

Agency

090 OFFICE OF MANAGEMENT AND ENTERPRISE SERV

Supervisory Organization

EGID - Member Services

Job Posting End Date (Continuous if Blank)

July 06, 2023

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

Up to $46,000.00 based on education and experience

Job Description

As a Call Center Specialist with OMES you will enjoy :

  • Generous leave including 15 days of vacation, 15 days of sick leave and 11 paid holidays annually.
  • A comprehensive with a generous to offset the cost of insurance premiums for employees and their eligible dependents.

Job Details

  • Full-time 40-hour work weeks.
  • Support the Employee Group Insurance Division
  • Salary up to : $46,000.00

Responsibilities

  • Answer calls in the call center loop from members, providers and insurance coordinators, interpreting the plans processes related to eligibility, enrollment, change, termination, retirement and COBRA by providing oral responses to queue generated calls or direct calls to active members, dependents, retired members, and survivors based on knowledge of rules, regulations, statutes and understand details of Centers of Medicare and Medicaid Services (CMS) guidelines as a contracted CMS provider as well as work processes or procedures that may apply.
  • Execute or respond to all paper, email or RightNow system communication in a timely manner, whether communication is from a member, supervisor, manager, peer or other source.
  • Maintain a complete and accurate log of each call taken or placed, each fax received or sent, and each email or paper correspondence received or assigned by Management.
  • Assist members by coordinating with other departments in claim, pharmacy, eligibility, premium billing or payment and / or policy issue resolution by researching and working in partnership with departments to resolve benefit concerns and ensure member satisfaction.
  • Troubleshoot health, dental benefits or pharmacy purchase denials or Prior Authorizations when an issue arises for member, provider, or pharmacy.
  • Assist in training new employees on all Call Center activity and materials when needed and provide immediate guidance to peers in response to call inquiries.
  • Review articles, manuals, publications for improving various public information / communications as well as the HealthChoice website to guide the caller or member to various resources, troubleshoot password issues and contribute to web content based on reported member call trends.
  • HIPAA Compliance - Must safeguard all Personal Health Information (PHI) by making sure work area is HIPAA compliant and all work stations are secure while away.

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.

Minimum Qualifications

  • A bachelor’s degree in business administration, public health administration or a related field or;
  • Four (4) years of experience in health, dental, life and disability customer service environment or;
  • An equivalent combination of education and experience.

About

The Office of Management and Enterprise Services provides 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.

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

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 State of Oklahoma employees must apply for open positions through their Workday account. Go to Careers app on WD home screen>

Click on 'Find Jobs-Internal State of Oklahoma'.

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Click on 'Find Jobs-Internal State of Oklahoma'.

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