Medical Claims Jobs in Oregon
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Search Results - Medical Claims Jobs in Oregon
Insight Global-Portland
The ideal candidate has strong medical and/or dental claims experience and is comfortable working in a lower‑volume, high‑accuracy environment.
Required Skills & Experience
• 2+ years of medical and/or dental claims processing experience
• Strong...
Intermountain Health-Salem
Job Description
The RCO Appeals Specialist is responsible for researching and appealing denied medical claims. Responsible to proactively identify insurance denial trends and to then work with Payer Contracting on these issues.
We are committed...
mindmatch.ai -
Remote
and the appropriateness of treatment setting and services delivered.
Start date is 6/1/2026
Responsibilities:
• Analyzes and Audits Claims. Integrates medical chart coding principles, clinical guidelines and objectivity in performance of medical audit activities. Draws...
icims.com -
Yamhill Community Care-Mcminnville (OR)
and conducting internal and external audits of Yamhill Community Care (YCCO) and its subcontractors, partners, and medical claims, as well as monitoring trends of non-compliance against established criteria such as policies and procedures, Oregon Administrative...
prismhr-hire.com -
Remote
projects within standard reports such as medical policies, state and federal statutes.
• Validates New Claim Types. With proficiency, utilizes audit tools to evaluate, document and validate to audit and client new claims and concept effectiveness. Ensures...
icims.com -
Remote
recognized care guidelines and comparing current care with industry standards.
• Review gaps in care and medical and pharmacy paid claims data to develop a comprehensive clinical profile; create individualized care plans and provide close follow-up...
icims.com -
Remote
months.
• 5 to 7+ years of working with a broad knowledge of medical claims, billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology.
• Adherence to official coding guidelines...
icims.com -
Remote
School Diploma or GED required. Bachelor's degree preferred.
• 5+ years related experience (Subrogation, healthcare billing, healthcare/medical claims, reimbursement, analytics, recovery, paralegal, adjusting).
• Experience in a Legal office of 3+ years...
icims.com -
Remote
on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.
Responsibilities:
Audits Outpatient and Specialty Claims:
• Utilizes medical chart coding principles and client specific guidelines...
icims.com -
Remote
tools (e.g., Airflow, Databricks Workflows).
• 3+ years of data analysis. Preferably in the Healthcare industry of enrollment, medical claims and/or pharmacy claims.
• Proficient in Microsoft Office Suite applications PowerPoint, Word, Excel and Outlook...
icims.com -
Remote
of treatment setting and services delivered.
Responsibilities:
• Analyzes and Audits Claims. Integrates medical chart coding principles, clinical guidelines and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise...
icims.com -
Remote
a coding certification within 6 months.
• 5 to 7+ years of working with a broad knowledge of medical claims, billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology.
• Adherence...
icims.com -
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