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Tulsa, OK, USA ● Req #667Monday, October 7, 2024JOB SUMMARY: The Customer Service Supervisor will build a strong team of Customer Service Representatives and shape staff behaviors to accomplish desired results to meet the expectations and needs of our members, providers and internal customers. You will be responsible for providing ongoing coaching to inspire our Customer Service Representatives to deliver exceptional customer service as well as coaching to develop CSRs in their current role or to take on additional responsibilities. You will ...Read more about Customer Service - Supervisor Customer Service 105-4001More
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Tulsa, OK, USA ● Req #666Monday, October 7, 2024JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will ...Read more about Customer Service - Customer Service Representative 105-1025More
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Tulsa, OK, USA ● Req #599Saturday, September 28, 2024JOB SUMMARY: Responsible for performing general clerical functions, departmental customer service and support. KEY RESPONSIBILITIES: Provide clerical support to department including copies, filing, mailing or faxing as directed. Process all incoming departmental mail and documents. Responsible for file retention, relocation and shredding. Responsible for departmental document imaging, auditing and indexing of imaged files. Assist other departmental members as needed and phone back-up. Perfo ...Read more about Provider Services - Support Specialist 115-1020 (part time)More
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Tulsa, OK, USA ● Req #647Friday, September 27, 2024The Medical Review Supervisor is responsible for overseeing activities and personnel involved in the day to day operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing and monitoring functions aimed at identifying areas of risk and/or potential fraud, waste and abuse, as it relates to provider billing practices. KEY RESPONSIBILITIES: Provides technical expertise to Medical Review (MRE) staff including analysis, problem solving, and ...Read more about Configuration - Supervisor Medical Review 200-4004More
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Tulsa, OK, USA ● Req #638Thursday, September 26, 2024JOB SUMMARY: The Software Engineer will build out the next generation of our platform. As a Software Engineer, you are expected to work independently, and within teams, leading the development of software features. You will be involved with the early stages of mentoring other team members and helping with identifying process improvements for the team. KEY RESPONSIBILITIES: •Implements features of the application and is proficient in one or more of the feature or components. •Leads independent ...Read more about Information Technology - Software Engineer 130-2048More
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JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. KEY RESPONSIBILITIES: Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making i ...Read more about Claims HMO - Claims Examiner_140-1006More
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Tulsa, OK, USA ● Req #661Tuesday, September 24, 2024JOB SUMMARY: Responsible for all inquiries from members and providers seeking resolution through the grievance and appeals process. KEY RESPONSIBILITIES: Investigates member complaints and communicates resolution to member (or authorized representatives) for all lines of business in accordance with CommunityCare’s grievance procedures. Investigates; prepares case files and presents cases for medical and/or administrative review. For all lines of business for non-complex post-service claims ...Read more about Quality Improvement - Grievance & Appeals Coordinator I_195-1007More
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JOB SUMMARY: The Analyst II provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing intermediate to advanced level reports and programs and programming modifications to previously written reports. The Analyst II will collaborate with key stakeholders and determine the needed result including any special specifications. The Analyst II will work with several databases to p ...Read more about Reporting - Health Data Analyst II 135-2004More