Top 16 Claims representative Jobs in Medford, Or

Appeals & Grievance Coordinator
AllCare Health —Grants Pass, OR
- $23 - $25 an hour
- Full-time
- Mid-level
- In-person
- 1 year
- Mileage reimbursement
- Health insurance
Quick Apply
6d
Account Representative - State Farm Agent Team Member
Devin Banks - State Farm Agency Intern —Medford, OR
- $20 - $22 an hour
- Full-time
- Communication skills
- Entry level
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Jon Snowden - State Farm Agent —Ashland, OR
- $18 - $22 an hour
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply
Account Manager - Personal Lines
Brown & Brown —Medford, OR
- Full-time
- Microsoft Word
- Microsoft Excel
- Bachelor of Science
- Employee stock purchase plan
- Paid holidays
Claims Processing Supervisor
AllCare Health —Grants Pass, OR
- $26 - $32 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
- Health insurance
- 401(k)
Quick Apply
5d
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)
Quick Apply
Insurance Coordinator
KAIROS —Grants Pass, OR
- $24.79 - $30.13 an hour
- Full-time
- Bilingual
- Clean driving record
- HIPAA
- AD&D insurance
- Paid holidays
Quick Apply
Licensed P&C Customer Service Representative-Full Benefits
Insurance Lounge, LLC —Medford, OR
- $24 - $26 an hour
- Full-time
- Hybrid work
- Mid-level
- Microsoft Office
- Health insurance
- Dental insurance
Quick Apply

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Appeals & Grievance Coordinator

AllCare Health -
Grants Pass, OR

Quick Apply

Job Details

Full-time
$23 - $25 an hour
6 days ago

Benefits

Mileage reimbursement
Health insurance
401(k)
Flexible schedule

Qualifications

Healthcare dispute resolution
Appeals
Insurance dispute resolution
CMS
Patient complaint handling
Mid-level
Certified Professional Coder
Medical insurance appeals management
1 year
Associate's degree
Insurance claims appeal handling
Customer complaint resolution

Full Job Description

Appeals & Grievance Coordinator at AllCare Health with the Quality department in Grants Pass, Oregon

We Are Seeking Qualified Candidates to Join Our Team!

AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

Summary

This position is responsible for processing and resolving the Oregon Health Plan and Advantage Health Plan members and provider appeals and grievances by performing the following duties.

Essential Duties

Investigates and resolves complex member and provider complaints related to enrollment and claims, provider payment disputes, medical appeals, and reversals within the health care industry.
Provides the medical director with a complete case file for processing of the appeals and grievances and coordinates care or payment of services.
Forwards appeals to CMS Independent Review Entity or to DMAP for further review.
Collaborates with DMAP, CMS, or the independent review entity for review.

All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education.

Job Requirements

May require the use of personal vehicle for local travel (subject to mileage reimbursement).

Education & Experience

Associate's degree (AA) from a two-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience.

Certificates, Licenses and/or Registrations

Certified Professional Coder (CPC) is strongly preferred.

Physical Demands & Work Environment

The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl. The noise level in the work environment is usually moderate. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

The employee must be able to work on-site for all scheduled shifts.

Company Overview

AllCare Health Website: https://www.allcarehealth.com.

AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp® status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at https://bcorporation.net/about-b-corps)

AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more.

The AllCare Health family of businesses is guided by our corporate principles:

Purpose | Working together with our communities to improve the health and well-being of everyone.

Values | Trust, Innovation, Relationships, and Voice.

Vision | Thriving, Inclusive, and Equitable communities.

Brand Promise | Changing Healthcare to Work for You.

AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others.

If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call 541-471-4106 and ask for Human Resources.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.

Monday - Friday; 8:00am - 5:00pm w/ a 1 hour unpaid lunch & two 15 minute paid breaks
40 hours per week

Quick Apply

Refine Your Search

claims representative jobs in medford, or

Appeals & Grievance Coordinator

Account Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Account Manager - Personal Lines

Claims Processing Supervisor

Certified Call Center Claims Processor I

Insurance Coordinator

Licensed P&C Customer Service Representative-Full Benefits

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