Umpqua Health is recruiting for a Billing Specialist to support the financial accuracy and operational efficiency of our health plan. In this role, you’ll be responsible for managing the end-to-end billing cycle, reconciling payments, ensuring compliance with payer contracts, and generating detailed reports that track service utilization and financial performance. You’ll collaborate across departments, utilize multiple platforms, and contribute to process improvements that enhance accuracy and transparency in billing operations. 

This position is ideal for someone who thrives in a fast-paced environment, has a passion for data integrity, and enjoys working across systems to improve financial outcomes in a healthcare setting. 

Your Impact: 

• Provide billing support services including invoice generation, monthly reporting, and payment reconciliation. 
• Follow up with payors regarding unpaid or partially paid invoices to ensure timely resolution and accurate accounts. 
• Archive billing records and maintain documentation that supports completed financial transactions. 
• Monitor approved services in Smartsheet and ensure alignment across platforms and departments. 
• Prepare regular reports and dashboards on utilization metrics, cost performance, and financial variances using tools such as Excel, SharePoint, Tableau, and CIM. 
• Process invoices related to utilization management services and ensure all billing aligns with payer contract terms and internal policies. 
• Assist with internal and external audits, ensuring billing and financial documentation meets compliance standards. 
• Contribute to departmental initiatives that support forecasting, financial impact analysis, and operational planning. 
• Support the development of dashboards and internal reports that track KPIs including cost per member, admission and readmission rates, and length of stay metrics. 
• Identify inefficiencies or patterns in claims and utilization data and make recommendations for process improvements. 
• Ensure compliance with federal and state regulations including CMS, Medicaid, and Oregon Health Authority billing guidelines. 
• Participate in team projects and contribute to department-wide deliverables as assigned. 
• Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values. 

Your Credentials: 

• High School Diploma or GED required. 
• 3–5 years of billing or finance experience, preferably in a healthcare or managed care setting. 
• Must meet background criminal history unit (CHU) approval requirements. 
• Proficient in Microsoft Office (Excel, Outlook, Word) and experienced with data platforms; Smartsheet, SharePoint, and Tableau knowledge is a plus. 
• Exceptional attention to detail with the ability to manage high-volume transactions and meet tight deadlines. 
• Strong organizational skills and the ability to prioritize tasks in a dynamic, evolving environment. 
• Excellent interpersonal and communication skills to collaborate effectively with internal teams and external stakeholders. 
• Demonstrated ability to think critically, troubleshoot billing discrepancies, and support process improvements. 
• Experience working independently, taking initiative, and contributing to team-based performance goals. 
• Physical ability to perform office-related tasks, including frequent computer use and light lifting. 
• Prior experience in Medicaid, CMS, or payer billing environments highly preferred. 

About Umpqua Health

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.