ECS Coordinator II

Job Posting Title

ECS Coordinator II

Agency

807 HEALTH CARE AUTHORITY

Supervisory Organization

Eligibility & Coverage Services

Job Posting End Date (Continuous if Blank)

August 11, 2025

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

Job Description

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, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office.

Position Purpose

The Eligibility and Coverage Services Coordinator II plays a critical role in supporting the Oklahoma Health Care Authority's mission by ensuring efficient and effective administration of SoonerCare and other Medicaid programs. This position is responsible for resolving member and provider inquiries, processing claims, managing member enrollments, and maintaining compliance with program policies. The role requires strong communication skills, attention to detail, and the ability to navigate complex program guidelines, all while maintaining a high standard of service to internal and external stakeholders.

Principle Activities May Include:

• Research and resolve provider and member inquiries, complaints, and denied claims.

• Investigate and address access to care issues, fraud, abuse, and quality assurance complaints.

• Interpret and communicate SoonerCare policies and procedures to providers, members, and stakeholders.

• Educate on program coverage, services, and eligibility guidelines for SoonerCare, BCC, DOC Inpatient, TEFRA, and Insure OK programs.

• Process and resolve electronic claims inquiries and claims reconciliation.

• Manage member applications, enrollments, plan changes, and eligibility verifications.

• Identify and report system discrepancies.

• Research and implement system updates and corrections.

• Stay current on SoonerCare rule revisions and program changes.

• Maintain organized reference materials and update written controls.

• Coordinate with other departments on referral issues and operational procedures.

• Communicate independently with members and stakeholders to resolve issues.

• Participate in special projects, member outreach, and educational efforts.

• Represent OHCA in meetings, seminars, and training forums.

• Support workflow during staff absences and manage high call volumes.

• Other duties as assigned.

Knowledge, Skills, Abilities, and Competencies

The Eligibility and Coverage Services Coordinator II requires in-depth knowledge of Medicaid program policies, strong communication skills for resolving inquiries, and the ability to manage complex administrative processes. This role demands attention to detail, effective collaboration, and the ability to navigate both member and provider concerns. The Korn Ferry competencies that align well with this position are Manages Complexity, for handling detailed program and policy administration, and Collaborates, for working effectively with both internal and external stakeholders to resolve issues and ensure program success.

To be considered for this position your application must include a resume/CV with complete work and education history.

Education and Experience

• 1 year of experience in clerical office work or as a customer services representative plus 2 years of experience in customer service, processing tax returns, bookkeeping or closely related work. OR

• An equivalent combination of education and experience, substituting thirty semester hours of college, including six semester hours in business or public administration for the required experience plus 2 years of experience in customer service, processing tax returns, bookkeeping or closely related work.

Preference may be given to candidates with:

• Certifications in any of the following areas: Certified Medicaid Professional (CMP), Customer Service or Call Center Management Certification, Project Management Certification (PMP), Lean Six Sigma Certification, Certified Health Data Analyst (CHDA), or Health Insurance Portability and Accountability Act (HIPAA) Certification

Physical Demands:

• Must be able to remain sitting for prolonged periods at a desk and working on a computer.
• Must be able to move or lift up to 15 pounds at various times.

Work Environment:

The office work environment includes regular exposure to general office equipment such as computer equipment, phones, and copy machines.

Why You'll Love Working Here

At the Oklahoma Health Care Authority (OHCA), we're proud to create a workplace where employees thrive. Named a Top Workplace in Oklahoma for five consecutive years, this achievement reflects the dedication and collaborative spirit of our incredible team. Here's what we offer to support employees and their family:

• Generous state-paid benefit allowance to offset insurance premiums.
• A wide selection of top-tier health insurance plans.
• Optional flexible spending accounts for health care or dependent care expenses.
• Employee Assistance Program (EAP) offering confidential support.
• Wellness benefits, including an on-site gym and fitness center discounts.
• 11 paid holidays annually.
• 15 vacation days and 15 sick days in your first year.
• Retirement Savings Plan with substantial employer contributions.
• Longevity Bonus to reward years of service.
• Public Service Loan Forgiveness eligibility and reimbursement for educational expenses.
• Professional development training opportunities, including CEU support.

Accommodation Statement:

The Oklahoma Health Care Authority complies with applicable 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. If a reasonable accommodation is needed to participate in 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.