Network Management Fee Schedule Specialist

State of Oklahoma • OK

75d • $31

About The Position

The Fee Schedule Specialist is responsible for maintaining, analyzing, and updating provider fee schedules to facilitate accurate claim pricing and reimbursement. This role requires a strong understanding of medical coding, reimbursement methodologies, and regulatory guidelines. The specialist works closely with provider relations, claims, compliance, and finance teams to support operational accuracy and efficiency.

Requirements

• High School Diploma or GED.
• 2 years of professional experience in medical coding, claims processing, or provider reimbursement.
• In-depth knowledge of insurance fee schedules and related state and federal legislation.
• Strong communication and collaboration skills.
• Meticulous attention to detail while managing multiple priorities.
• Ability to problem solve, both analytically and strategically.

Nice To Haves

• Certified Professional Coder (CPC) or equivalent medical coding experience.
• Proficiency with Microsoft Excel.
• Experience with claims processing systems.

Responsibilities

• Maintain and update provider fee schedules within internal systems to facilitate accurate claim adjudication.
• Analyze fee schedules for accuracy, consistency, and compliance with state, federal, and contractual requirements.
• Research, interpret, and apply coding updates to reimbursement schedules.
• Collaborate with internal teams to resolve claim pricing issues and discrepancies.
• Monitor regulatory and industry changes affecting reimbursement methodologies and implement necessary updates.
• Assist with provider contract implementation by ensuring accurate fee schedule configuration.
• Support audits, compliance reviews, and reporting related to reimbursement.
• Communicate clearly with providers and internal stakeholders regarding reimbursement policies and methodologies.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED