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Coding Investigative Spec
HCSC - Tulsa, OK
***This position will sit in the Tulsa, OK office*** BASIC FUNCTION: This position is responsible for maintaining all department audit, savings and appeals databases, preliminary research on inquiries, appeals, and requests for assistance in preparation of auditor completion, providing assistance for investigative auditing, development a...
Medical Director of Behavioral Health
HCSC - Tulsa, OK
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health...
Account Executive I
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for ensuring continued and increased growth by negotiating renewals or selling products and services to existing customers, understanding customer needs, and providing customer support. JOB REQUIREMENTS: * Bachelor's degree and 1 year of health insurance account management/sales support experience OR Bachelor degree and ...
Associate Contract Specialist
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for drafting account-specific documents for new and renewing accounts using the Master as a base and specifications from Marketing. JOB REQUIREMENTS: * Experience with insurance contracts. * Knowledge of health insurance products. * Experience in deadline-driven work. * Verbal and written ...
Communications Consultant II
HCSC - Tulsa, OK
***This position to be filled in either Tulsa or Oklahoma City only*** BASIC FUNCTION: This position is responsible for developing and executing a variety of communications to meet the needs of multiple audiences by drafting, editing and supervising the production of communications distributed to various audiences. JOB REQUIREMENTS: * Bachelor Degree...
RN Appeals Medical Reviewer
HCSC - Tulsa, OK
**This position is located in Tulsa, OK** BASIC FUNCTION: This position is responsible for coordinating appeals for all lines of business; reporting, monitoring, scheduling and facilitating appeals according to various regulatory requirements; requirements include, Department of Insurance, DOL-ERISA and Accreditation standards...
Sr Contract Specialist
HCSC - Tulsa, OK
Job Purpose: This position is responsible for drafting of standard and customized account-specific documents for new and renewing accounts with redrafts of up to ten paragraphs. This position is responsible for drafting non-standard contract language and coordinating the production of documents working with account managers. This posit...
Contract Specialist
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for drafting of standard and customized account-specific documents for new and renewing accounts with redrafts of up to ten paragraphs. This position is responsible for drafting non-standard contract language and coordinating the production of documents working with account managers. This position is responsibl...
Provider Network Associate
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for supporting Medicare and Medicaid provider services, provider operations and contracting of individual Medicare and Medicaid providers. This position is accountable for researching and resolving provider inquiries arising from contract operations, system, data entry claims payment, and directory issues. This po...
Medical Dir Behavioral Health
HCSC - Tulsa, OK
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health...
Network Management Consultant
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for providing support to the provider recruitment and contracting process to ensure strategic coverage of providers for assigned territory. Specific responsibilities include small to mid-size contract negotiations for small hospitals, physicians and physician groups and developing and maintaining relationships wit...
Behavioral Health Care Coordinator
HCSC - Tulsa, OK
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health...
Care Coordinator UM/CM I
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and i...
Coding Investigator Auditor - Tulsa, OK
HCSC - Tulsa, OK
At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" as one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.
Reimbursement Analyst
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for developing reports based on a number of internal/external databases using SAS or a similar programming language; reporting includes pricing models for network negotiations and fee schedule updates used for claims adjudication; validating and researching report results using the original operation systems and the reporting data...
