EGID Business Analyst
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Job Location:
Oklahoma City, OK - USA
Monthly Salary:
Not Disclosed
Posted on:
5 days ago
Vacancies:
1 Vacancy
Job Summary
Job Posting Title
EGID Business AnalystAgency
807 HEALTH CARE AUTHORITYSupervisory Organization
EGIDJob Posting End Date
Refer to the date listed at the top of this posting if available. Continuous if date is blank.
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 timeJob Type
RegularCompensation
$60000 / annualWhy Youll Love Working Here
At the Oklahoma Health Care Authority (OHCA) your work matters. Every day our team helps ensure Oklahomans have access to better health and better care. Guided by our core values Passion for Purpose Trust & Transparency Empowerment & Accountability Best-in-Class Outcome-Driven and Servant Leadership we foster a workplace where people feel supported respected and empowered to make an impact. Learn more about OHCA.
Lets Talk Benefits
We know your great work deserves great support. Heres a snapshot of what we offer for all eligible employees.
Generous state-paid benefit allowance to offset insurance premiums.
A wide selection of insurance plans with no pre-existing condition exclusions.
Flexible Spending Accounts for health care and dependent care.
11 paid holidays annually.
15 days of vacation and 15 days of sick leave in the first year.
Longevity Bonus recognizing years of public service.
Public Service Loan Forgiveness eligibility and tuition reimbursement.
Wellness benefits including an on-site gym and fitness center discounts.
Job Description
Location: 4345 N Lincoln Blvd Oklahoma City OK 73105
Salary: (INSERT SALARY INFO FROM FTE CR)
Work Schedule: Monday Friday
Primary Hours: 8:00 a.m. 5:00 p.m.
Agency/Division Information
The Oklahoma Health Care Authority (OHCA)works to ensure Oklahomans have access to better health and better care.The agencys core values include passion for purpose trust and transparencyempowermentand accountability best in class and outcome-driven and servant leadership.As part of the interview process candidates maybe requiredto attend an in-person interview at our Oklahoma City office.
Position Purpose
The Business Analyst within the Internal Audit and Fiscal Analysis division of EGID plays a critical role in ensuring the integrity and accuracy of health dental and life claim audits. This positionis responsible forconducting detailed audits supporting data analysis projects and collaborating with internal and external stakeholders to ensure compliance with plan design and benefits. The role also involves developing processes and procedures for efficient auditingmaintainingcomprehensive reports and providing expert support across various functions within the division to ensure accountability and optimize operations.
PrincipalActivitiesMay Include:
Audit health dental and life claims to ensure correct plan design benefits pricing provider matching etc. have been performed by the TPA.
Utilize software to analyze large data sets for audit focus areas.
Review processed claims todetermineadherence to plan design benefits and pricing methodologies.
Work with the TPAs toidentifydeficiencies in claims processing and appraise the adequacy of corrective measures taken.
Appraise plan design and benefits todeterminecompliance with applicable state and federal coverage mandates.
Use a tracking system or other tools tomonitoraudit activities and document work.
Make written and oral presentations quantifying areas of focus and results.
Develop and use data analytics methods toidentifyand report on plan healthcare cost trends.
Develop processes and procedures toassistwith effective and efficient claim audits.
Develop andmaintainreporting of audit results.
Support claim appeals function provider Network Management unit TPA Management unit and other areas within the division.
Coordinate with external auditors for audits related to health and dental claims.
Other duties as assigned.
Knowledge Skills Abilities and Competency Requirements
The Business Analystrequiresa strong understanding of health dental and life claim auditing processesexpertisein data analytics and effective communication skills for coordination with auditors and other stakeholders. Additionally the role demands theability to develop and implement processes for efficient audits and perform root cause analysis for claims adjustments. The most relevant Korn Ferry competencies for this position includeDecision Quality as the analyst must accurately assess claims and audit findings andOptimizes Work Processes reflecting the need to enhance audit procedures for efficiency and accuracy.
**To be considered for this position your application must include a resume/CV with complete work and education history.**
Education and/or Experience:
Bachelors degreeAND
2years of professionalauditing experienceOR
An equivalent combination of education and experience substituting one year of professional or technical administrative experience in business or public administration for each year of the required education.
NOTE: No substitution will be allowed for the required professional experience in a supervisor or administrative capacity.
Preference Qualifications Include:
Bachelors degree in accountingfinance orbusiness.
Certifications in any of the following areas: Certified Public Accountant (CPA) Certified Internal Auditor (CIA) Certified Fraud Examiner (CFE) Certified Information Systems Auditor (CISA) or Certified Government Auditing Professional (CGAP)
Physical Demands andWork Environment
Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels.In the course ofperforming job duties employeesare required tospeak stand walk and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.
Accommodation Statement
The Oklahoma Health Care Authoritycomplies withapplicable 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. Ifa reasonableaccommodation is needed toparticipatein 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 .
Notice to applicants:
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 WorkdayJobs 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.
If you are needing any extra assistance or have any questions relating to a job you have applied for please click the link below and find the agency for which you applied for additional information:
Required Experience:
IC
