Medicaid Eligibility & Coverage Specialist II

State of Oklahoma; Oklahoma; On-site; USD 30,000 - 33,000; Full time

Benefits offered by this job

State benefits

Insurance plans

FSAs

Retirement plan

Holidays

Paid vacation/sick leave

Longevity bonus

Loan forgiveness

Wellness on-site gym

Job summary

The Oklahoma Health Care Authority is seeking an Eligibility and Coverage Services Coordinator II to support SoonerCare and Medicaid programs. You will resolve inquiries, process claims, manage enrollments, and ensure policy compliance, delivering high-quality service to internal and external stakeholders.

The role emphasizes clear communication, attention to detail, and the ability to operate within evolving program guidelines while collaborating with other departments and maintaining organized

Qualifications

• Understanding of Medicaid program policies and procedures.
• Strong written and verbal communication skills.
• Ability to navigate complex program guidelines and maintain service quality.

Responsibilities

• Resolve member and provider inquiries and denied claims.
• Investigate access to care issues, fraud, abuse, and quality concerns.
• Educate on SoonerCare policies to providers and members.
• Process and reconcile electronic claims and enrollments.

Skills

Medicaid policies

Communication

Administrative processes

Education

Equivalent combination of education and experience

Job description

The Oklahoma Health Care Authority is seeking an Eligibility and Coverage Services Coordinator II to support SoonerCare and Medicaid programs. You will resolve inquiries, process claims, manage enrollments, and ensure policy compliance, delivering high-quality service to internal and external stakeholders.

The role emphasizes clear communication, attention to detail, and the ability to operate within evolving program guidelines while collaborating with other departments and maintaining organized