Provider Payment Specialist-HOT (Public Service Rep 4) multiple positions

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If this opportunity aligns with your strengths, background, and commitment to fostering inclusivity, we encourage you to apply! At the Oregon Health Authority (OHA), we value diversity and encourage applicants from all backgrounds and experiences to help us build a stronger, more equitable future for all.

The Provider Services Unit (PSU) offers support to healthcare providers, assisting with claims reviews, payment approvals, and technical inquiries via phone and email, while also addressing billing issues with Medicaid members.

In this position, you will assist in-state and out-of-state health care providers in obtaining correct and timely Medicaid reimbursement through a provider-dedicated Customer Service Center environment. You will serve as a key customer service and technical support resource, using the statewide Automatic Call Distribution (ACD) phone system, provider web-based tools, email, and written correspondence to respond to complex Medicaid billing inquiries. You will interpret and explain Medicaid rules and Oregon Administrative Rules, researches and resolves provider questions, guides providers through billing and program requirements. You will also conduct complex claims payment research and analysis that supports accurate and timely reimbursement and promotes program integrity. You will review and evaluate electronic and paper claims, identify errors and discrepancies, determine corrective actions, and make payment-impacting decisions in alignment with Medicaid policy and authorized claim-resolution procedures. In managing a high-volume workload, you will set work priorities to meet established timeframes and maintain responsive customer service.

You will have the privilege and responsibility to factor in the perspectives of diverse populations most harmed by social injustice and inequities including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA+ and other communities that have been traditionally marginalized. 

• Complete any pending tasks in Workday under “My Applications” prior to the application deadline.
• Check your email (including junk folder) and Workday inbox regularly for updates on your application.

• Eligible veterans and Oregon National Guard servicemembers (current and former) who meet the qualifications of the position will be awarded candidate preference. To protect your information and ensure correct processing, please follow the instructions for submitting your Veterans’ Preference documentation.
• Please download and save a copy of this job announcement and linked position description, as it is not available after the application deadline.

About the Team & Benefits of Joining

We offer a workplace that balances productivity with enjoyment; promote an atmosphere of mutual respect, dedication, and enthusiasm. You will collaborate with a team of bright individuals to work with and learn from.

If you're driven by the passion to do something meaningful that changes lives, the Oregon Health Authority is the place for you. We also offer a competitive benefits package including:

·         Excellent, low-cost medical, vision, and dental coverage for you and your family.

·         Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare.

·         Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month.

·         Potential eligibility for the Public Service Loan Forgiveness Program.

·         Retirement security through Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP).

·         Training and development opportunities to grow your career with the State of Oregon.

• This announcement is for nine (9), full-time, permanent, SEIU represented, Provider Payment Specialist (Public Service Representative 4 positions based in Salem, Oregon.
• This is hybrid  with 10% in-office expectation. “Review Section 4: Working Conditions” in the position description (linked above) for more information.
• Employment is contingent upon a criminal records check and a driving records check that meets OHA criteria at the time of hire and throughout employment.
• The salary listed is the non-PERS qualifying range. If the successful candidate qualifies for PERS, the salary range will increase by 6.95%. For more information, see the Classification and Compensation page.
• The State of Oregon does not request or require your age, date of birth, attendance or graduation dates from an education institution during the application process.
• This position does not provide visa sponsorship. Within three days of hire, you will be required to complete I-9 documentation and confirm authorization to work in the United States. OHA will use E-Verify to verify work authorization. If your employment eligibility depends on sponsorship now or in the future, you will not meet the requirements for this position.
• We evaluate candidates based on their own skills and experience. Unless explicitly approved, outside resources – including Artificial Intelligence (AI) tools – are not permitted during assessments or interviews. Use of unauthorized resources will disqualify a candidate from further consideration.

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The Oregon Health Authority is an affirmative action and equal opportunity employer, committed to fair employment practices and pay equity for all employees. We do not discriminate based on protected class – including race, sex, veteran status, disability, age, color, religion, national origin, marital status, or sexual orientation – and does not screen applicants based on current or past compensation. Salary is determined through a fair review of your education, experience, and training as it relates to the position.

OHA is an anti-racist organization working to eliminate health inequities and dismantle structural barriers that impact underserved communities. Join us in advancing our Strategic Plan and building a more equitable Oregon.