Top 12 Medical claims processor i Jobs in Oregon

Medical Claims Processor I
Moda Health —Milwaukie, OR
- $17.34 - $19.41 an hour
- Overtime
- Medical office experience
- High school diploma or GED
- Typing
- Paid holidays
- Health insurance
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Medical Claims Auditor I
Moda Health —Milwaukie, OR
- $18.39 - $20.58 an hour
- Weekends as needed
- Remote
- Customer service
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
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Medical Claims COB Processor I
Moda Health —Milwaukie, OR
- $18.39 - $20.58 an hour
- Weekends as needed
- Word processing
- High school diploma or GED
- Continuous improvement
- Paid holidays
- Health insurance
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Dental Claims Processor I
Moda Health —Milwaukie, OR
- $17.34 - $18.36 an hour
- Weekends as needed
- Hybrid work
- Office
- High school diploma or GED
- Data entry
- Paid holidays
- Health insurance
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Certified Claims Processor I
AllCare Health —Grants Pass, OR
- $20 - $24 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
- Health insurance
- 401(k)
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Certified Call Center Claims Processor I
AllCare Health —Grants Pass, OR
- $20 - $24 an hour
- Full-time
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- 401(k)
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Government Programs Appeal Coordinator I
Moda Health —Milwaukie, OR
- $21.30 - $23.96 an hour
- Overtime
- Hybrid work
- Writing skills
- Research
- High school diploma or GED
- Paid holidays
- Health insurance
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Claims Processor
Zenith-American —Tualatin, OR
- Full-time
- Computer literacy
- Writing skills
- Basic math
- AD&D insurance
- Health insurance
10d
Supervisor, Medical Claims
Moda Health —Milwaukie, OR
- $59,922.05 - $74,902.56 a year
- Weekends as needed
- Hybrid work
- Management
- Word processing
- Computer literacy
- Paid holidays
- Health insurance
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Senior Incentive Processor
CLEAResult Consulting Inc. —Salem, OR
- $18.55 - $26.00 an hour
- Full-time
- Residential
- Continuous improvement
- US work authorization
- Health insurance
- Dental insurance
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9d

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Medical Claims Auditor I
Moda Health —Milwaukie, OR
Audit claims daily statistically valid sampling method, using prescriber audit criteria. Conduct in-depth claims audits on performance groups, as well as focus…
$18.39 - $20.58 an hour
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Lead Medical Claims Auditor I
Moda Health —Milwaukie, OR
Includes monitoring of assignments and overtime, evaluating performance, training, communicating policy to staff, and answering questions from Claims Auditors…
$20.88 - $23.49 an hour
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Medical Claims Processor I

Moda Health -
Milwaukie, OR

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Job Details

Full-time
$17.34 - $19.41 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching

Qualifications

High school diploma or GED
Typing
10 key typing

Full Job Description

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
Responsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderately complex medical claims in accordance with policies, procedures, and guidelines as outlined by the company. This is a FT WFH role.

Pay Range
$17.34 - $19.41 hourly, DOE.

Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.
https://j.brt.mv/jb.do?reqGK=27778986&refresh=true

Benefits:

Medical, Dental, Vision, Pharmacy, Life, & Disability
401K- Matching
FSA
Employee Assistance Program
PTO and Company Paid Holidays

Required Skills, Experience & Education:

High School diploma or equivalent
6-12 months data entry or medical office experience preferred
10-key proficiency of 135 spm
Type a minimum of 35 wpm
Knowledge of medical terminology, CPT codes and ICD-9/10 codes preferred
Demonstrates work habits that include punctuality, organization, and flexibility
Ability to maintain balanced performance in areas of production and quality
Analytical reasoning and flexibility
Professional and effective written and verbal communication skills
Experience with Facets platform a plus
Identify all the duties and responsibilities

Primary Functions:

Enters claims data into system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures.
Review, analyze, and resolve claims through the utilization of available resources for moderately complex claims.
Analyze and apply plan concepts to claims that include deductible, coinsurance, copay, out of pocket, etc.
Examines claims to determine if further investigation is needed from other departments and routes claims appropriately through the system.
Adjudication of claims to achieve quality and production standards applicable to this position.
Release claims by deadline to meet company, state regulations, contractual agreements, and group performance guarantee standards.
Reviews Policies and Procedures (P&P’S) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements.
Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, state, and departmental confidentiality guidelines.
Flexible schedule that may include working 5 hours of overtime on pre-determined Saturdays to meet business needs. Moda’s standard workweek is a 37.5 hour work week.

Working Conditions & Contact with Others:

Office environment with extensive close PC and keyboard work with constant sitting. Must be able to navigate multiple screens. Flexible schedule that may include working 5 hours of overtime on pre-determined Saturdays to meet business needs. Moda’s standard workweek is a 37.5 hour work week.
Works internally with the customer service, membership accounting, and appeals departments. Works externally to support client needs.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our [email protected] email.

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Refine Your Search

medical claims processor i jobs in oregon

Medical Claims Processor I

Medical Claims Auditor I

Medical Claims COB Processor I

Dental Claims Processor I

Certified Claims Processor I

Certified Call Center Claims Processor I

Government Programs Appeal Coordinator I

Claims Processor

Supervisor, Medical Claims

Senior Incentive Processor

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