Get a reply from this employer
Your resume and cover letter, tailored to exactly what they’re hiring for.
The Oregon Department of Human Services is seeking a Health Insurance Analyst (Administrative Specialist 1) to input third-party insurance details, verify Medicaid coverage, and support enrollment in Coordinated Care. You will participate in Lean teams, manage referrals, and ensure accurate data handling within the Medicaid Management Information System.
Applicants should have strong attention to detail, experience with health insurance benefits, and effective communication skills for phone and
Initial Posting Date: 10/21/2026 Application Deadline: 10/28/2026 Agency: Department of Human Services Salary Range: $3,798 - $5,193 Position Type: Employee Position Title: Health Insurance Analyst, Administrative Specialist 1
The Oregon Department of Human Services is proud to be an Equal Opportunity Employer. We are guided by our Equity North Star and our vision for a positive RiSE organizational culture that advances equity and diversity. We encourage applications from members of historically underrepresented racial/ethnic groups, women, individuals with disabilities, veterans, LGBTQIA2S+ community members, and others to help us achieve our vision of a diverse and inclusive community.
The Oregon Department of Human Services is looking for a motivated, detail‑driven professional to join our Health Insurance Group within the Office of Payment Accuracy and Recovery. As a Health Insurance Analyst (Administrative Specialist 1), you will help make a real difference for Oregon’s Medicaid clients. In this role, you will ensure third‑party insurance information is entered accurately and on time, helping prevent unnecessary Medicaid costs, supporting recovery of incorrect payments, and ensuring clients receive the benefits they deserve. You will also help clear outdated exemptions so clients can enroll in the right Managed Care plans. If you enjoy meaningful work, problem‑solving, and being part of a supportive team that values accuracy and service, we want you on our team!
As a Health Insurance Analyst, you will: Contribute to continuous process improvement by participating in Lean‑focused teams and committees. Coordinate daily workflow and support team operations. Complete assignments from leadership in a timely manner. Review updated policies and procedural materials as required. Maintain an organized workstation and effective workload management.
Independently review, analyze, and research Third Party Resource referrals to determine completeness and eligibility for entry into the Medicaid Management Information System. Verify current and past Medicaid coverage using system eligibility screens. Assess whether referrals contain new information, duplicate existing records, or require additional research. Research historical information in available state systems when referral details are incomplete and return unverified referrals to the source when necessary. Identify Child Protective Services and Domestic Violence cases and determine appropriate actions to protect confidentiality and safety. Process referrals from multiple work queues, including phone calls, inbox submissions, webforms, internal reports, and other designated sources. Contact insurance carriers to request and verify policy information and provide clear explanations of applicable laws, rules, and confidentiality requirements. Gather and assess insurance information from carrier websites to determine accuracy and completeness. Enter, update, and maintain Third Party Resource records in the Medicaid Management Information System and ensure accuracy of all changes. End special Medicaid exemption conditions when appropriate to support enrollment into a Coordinated Care Organization. Notify referral sources of actions taken when required. All staff log into the call system and rotate answering calls throughout their shift. Inbox referrals are assigned on a daily rotation based on business needs.
A cover letter describing how you meet each of the essential attributes and minimum qualifications listed is required as part of the application.
The use of outside resources such as Artificial Intelligence software during applicant skill assessments, examinations, and/or interviews is prohibited unless otherwise stated by the hiring agency.
The State of Oregon does not request or require your age, date of birth, attendance or graduation dates from an educational institution during the application process.
The job posting closes at 11:59 PM (PDT/PST) on the close date.
Work is performed remotely, involving extended periods of sitting for computer and phone work. The role is primarily independent, with limited peer‑to‑peer interaction. Communication with team members occurs mainly through Microsoft Teams Instant Messaging, with weekly virtual meetings conducted via MS Teams using cameras, headsets, or mobile devices. The position occasionally involves phone or email interactions with individuals who may be upset, emotional, or confrontational. You may be required to come into the office in Salem quarterly for meetings, training, business or operational needs. The working hours for this position are 8:00am to 5:00pm, Pacific Standard Time.
If selected as a finalist, we will conduct a criminal history and background check. Adverse criminal history or background check may lead to disqualification. Additional background check information. The Oregon Department of Human Services does not offer visa sponsorship. Within three days of hire, you will be required to complete the US Department of Homeland Security’s I‑9 form confirming authorization to work in the United States. ODHS will use E‑Verify to confirm that you are authorized to work in the United States.
Eligible Veterans and Oregon National Guard servicemembers (current and former) who meet the qualifications of the position will be awarded candidate preference. For more information, please visit Veterans Resources.
This is a permanent, full-time position and is represented by the Service Employees International Union (SEIU). This recruitment may be used to fill future vacancies in the same classification.
Recruiter for this position is Nora Leyva Esquivel. Email: Nora.L.LEYVA-ESQUIVEL@odhs.oregon.gov Phone: 503-269-4222