Provider Payment Specialist

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. 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. Minimum Qualifications: At least two years of this experience must include dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance. Desired Attributes: ' Demonstrated experience building and maintaining constructive, collaborative working relationships to support policies, programs, and services that promote equity, inclusion, and incorporation of lived experience. ' Demonstrated experience explaining, interpreting, and applying laws, rules, and policies through clear verbal communication and well-documented written materials. ' Demonstrated experience researching, reviewing, and applying federal and state regulations, including Medicaid requirements, to support daily decision-making and determine appropriate outcomes. ' Demonstrated experience researching, reviewing, and resolving complex healthcare claims, billing, reimbursement, or payment-related issues while meeting productivity and quality expectations. ' Demonstrated experience synthesizing information from multiple sources and analyzing data using tools and technical information systems, including Microsoft Excel, Word, Outlook, Microsoft Teams, SharePoint, and healthcare claims-processing systems, to support program operations and determine appropriate resolutions. ' Demonstrated experience providing training, technical assistance, or subject-matter support related to policies, procedures, systems, billing, or program requirements. ' Demonstrated ability to independently plan, prioritize, and manage workload in a fast-paced environment with shifting priorities.