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Oklahoma State Government

Purchases state-funded health care; ensures quality

Adjudicator

Regulatory Compliance & EthicsConfirmed live in the last 24 hours
Full-time$45k - $48.8k /yrIn-person

About the Job

Requirements

  • Five years of experience in employment services, career or vocational guidance and counseling, personnel, recruitment, training, customer services, or social-services-related work, or an equivalent combination of education and experience, with 30 semester hours substituting for three years of required work experience.
  • Proficiency with OESC standard software, including Microsoft Word, Outlook, Excel, Access, and Teams, and the Internet, with the ability to learn other software as needed.
  • Ability to lift, carry, and move objects weighing up to 25 pounds.
  • Typing ability of 50 words per minute is a plus.

Responsibilities

  • Ensure due process for employers and claimants according to state and federal guidelines.
  • Conduct fact-finding with claimants and employers by phone, mail, and email to gather information needed to issue non-monetary decisions that meet benefits, timeliness, and quality measures.
  • Add potential issues when necessary for the adjudication process or release them.
  • Enter claimant overpayments and ensure complete documentation is in the file for the appeal process.
  • Accurately complete data entry into the computer system and each file's Claim Record Card, and write non-monetary determinations clearly for claimants and employers.
  • Follow OESC safety and security protocols.
  • Participate in required Division training.
  • Attend the on-site workplace and interact directly with staff and clients while using on-site office resources.

Desired Qualifications

  • Bilingual Spanish is preferred.
  • One year of call center experience is preferred.

About the Company

Oklahoma State Government

Purchases state-funded health care; ensures quality

The Oklahoma Health Care Authority manages the costs of state-purchased health care in Oklahoma, using state and federal funds to procure services for eligible residents. It distributes funds to purchase care, monitors costs, enforces quality standards, and builds partnerships to improve access and outcomes. It differs from private payers by being a government agency that coordinates public funding and policy for vulnerable populations, focusing on cost containment and public accountability. Its goal is to provide accessible, high-quality, publicly funded health care for Oklahoma residents in a fiscally responsible way while continually improving purchasing strategies and partnerships.

Company size
201-500
Company stage
Grant
Total funding
$4.2M
Headquarters
Oklahoma City, OK
Founded
1953

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