Provider Billing & Compliance Analyst (4 positions)

The Medicaid Division is responsible for the design, development, implementation, monitoring, evaluation, and improvement of publicly funded Medicaid programs and related health programs, including the Oregon Health Plan (OHP), Healthier Oregon, the OHP-Bridge Program, and initiatives under 1115 demonstration waivers, state plan authorities, and 1915 home and community-based services waivers.

The Provider Billing and Compliance Team is responsible for resolving billing complaints submitted by Oregon Health Plan members by researching complex eligibility, provider enrollment, and claims issues; applying Oregon Administrative Rules (OARs), Code of Federal Regulations (CFRs), and agency policy; resolving discrepancies; guiding providers; and rendering formal compliance determinations. In this position, you will protect program integrity by ensuring billing practices are accurate, compliant, and consistently applied through individual case review and technical support.

What We Are Looking For

Minimum Qualifications:

Any combination of experience or education equivalent to three years technical-level experience that typically supports the knowledge and skill requirements listed for the classification.

Desired Attributes:

• Knowledge of health services delivery systems, particularly the Oregon Health Plan (OHP), Medicaid administration in Oregon, provider enrollment, healthcare claims processing, Coordinated Care Organizations (CCOs), and related health and social service systems.
• Knowledge of legislative and regulatory processes, including experience analyzing, interpreting, and applying federal and state Medicaid laws, regulations, policies, and program requirements; specific knowledge of Oregon Administrative Rules (OARs) and Oregon Revised Statutes (ORS) is valued.
• Preference may be given to candidates with knowledge of Medicaid Fee for Service billing and Coordinated Care Organizations (CCOs) and extensive experience working within complex healthcare systems, including researching and resolving multifaceted claims, billing, eligibility, enrollment, or compliance issues. Ideal candidates will also have experience providing technical assistance and collaborating with healthcare providers, managed care entities, and partner agencies to explain complex policies, procedures, and billing requirements while supporting consistent, accurate, and equitable program administration.
• Experience analyzing and synthesizing quantitative and qualitative information to identify trends, resolve complex issues, support operational decision-making, and improve program performance and compliance, including experience working with complex information systems and data.
• Experience fostering constructive and collaborative working relationships across teams and organizations while coordinating work, facilitating communication, and supporting continuous quality, process, or operational improvements.
• Strong oral and written communication skills across a variety of forums, including experience preparing reports, technical correspondence, presentations, and communicating complex qualitative and quantitative information in ways that are accessible, inclusive, culturally responsive, and appropriate for diverse audiences.
• Experience managing multiple priorities and complex workloads while maintaining accuracy, exercising sound judgment, and meeting established timelines in a fast-paced, highly regulated environment.

Preference may be given to candidates who possess the following job-related knowledge, skills, and abilities: ability to read, write, and speak English and Spanish, or for one of these common languages in Oregon other than English (Chinese, Russian, Vietnamese) with full proficiency.

About the Team & Benefits of Joining

• 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 4, full-time, permanent, SEIU represented, Provider Billing & Compliance Analyst (Program Analyst 1) positions based in Salem, Oregon.
• These are hybrid (5% in-office) positions.

How to Apply:

Submit your application at oregonjobs.org using job number REQ-203714.

Application Deadline:  07/26/2026

Salary Range:  $4,519 - $6,904

How to Apply:

Submit your application at oregonjobs.org using job number REQ-203714.

Application Deadline:  07/26/2026