Policy Specialist (Medicare/Medicaid)

Location: Oklahoma City, Oklahoma, United States; primarily office-based

Company

A federal contractor and holding company supporting government and commercial organizations through business services, health, infrastructure, engineering, mission optimization, technology, and transportation subsidiaries.

What you will do

• Review and implement Coordination of Benefits and Medicare Secondary Payer policy guidelines for the Benefits Coordination and Recovery Center contract.
• Provide technical guidance on applicable statutes, regulations, CMS policies, Medicare laws, HIPAA, and related operational requirements.
• Review and provide feedback on standard operating procedures, BCRC letters, technical direction, joint operating agreements, and CMS change requests.
• Coordinate with training staff, SOP specialists, compliance officers, auditors, and other cross-functional teams to maintain procedural consistency.
• Identify trends, recommend process improvements, and implement approved procedural changes while meeting contractual quality and performance standards.
• Maintain confidentiality, privacy, data integrity, and security when handling sensitive information.

Requirements

• U.S. citizenship or permanent resident status is required for the Homeland Security Investigation background check.
• Ability to obtain and maintain the required customer clearance.
• Bachelor’s degree and at least 8 years of relevant Medicare Secondary Payer recovery experience, or an equivalent combination of education and experience.
• Extensive experience interpreting CMS Coordination of Benefits and Medicare Secondary Payer recovery policies, including CMS Internet-Only Manual guidelines.
• Knowledge of Medicare policies, procedures, MSP-related systems, HIPAA, and Microsoft Office Suite.
• Strong analytical, communication, problem-solving, organizational, project-management, and conflict-resolution skills; ability to travel and work between 6:00 a.m. and 7:00 p.m. as needed.

Culture & Benefits

• Full-time employment with medical, dental, vision, life, short-term disability, and long-term disability insurance.
• 401(k) plan with immediate vesting.
• Paid time off and 11 federal holidays.
• Family planning and fertility assistance, legal aid, and employee assistance programs.
• Professional development, training, and development opportunities.
• Drug-free workplace with equal employment opportunities for people with disabilities and veterans.