Clinical Data AMS Sr. Consultant DeloitteClinical Data AMS Sr. ConsultantPortland, OR$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
NewCertified Medical Coder (ONGOING POSITION) Macpower Digital Assets Edge Private LimitedCertified Medical Coder (ONGOING POSITION)Clackamas, ORRemote$30.67–$37.93 / hourSelected Certified Medical Coder must be located in the Portland, OR Metro Area, while our preferences will go to candidates live within the Portland Metro Area or Southern Washington state counties like Clark and Cowlitz County . What are the nice-to-have skills: Prior experience using MS Excel, OneNote, Teams -- MS Office Suite.
Director Clinical Operations and Medical Policy Cambia Health Solutions IncDirector Clinical Operations and Medical PolicyPortland, ORDemonstrated knowledge of the following: Health Plan and benefit design structures and application; Medicare/CMS regulations and applicability in administering the Medicare Product; Pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; Knowledge of health care coding and payment systems (such as ICD-10, CPT, HCPCS, NDC); Compliance related activities, legislative and regulatory activities, health insurance operations, or legal research helpful; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA. These activities include services pertaining to: evidence reviews of medications, formulary development, Pharmacy and Therapeutics (P&T) Committee support, medication use policy development, the Medication Policy Group (MPG), clinical prior authorization, implementation of utilization management activities, guidance for clinical edit coding for prescription claims processor or medical claims system, medication pipeline monitoring, medication trend management, and consultation and guidance on medication-related issues.
Program Integrity Investigator TriWest Healthcare AllianceProgram Integrity InvestigatorPortland, ORRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Portland, ORRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Accounts Receivable Specialist United Wound HealingAccounts Receivable SpecialistPortland, ORRemote$24–$27.25 / hourClaims Knowledge:Strong ability to read and understand EOBs; deep understanding of insurance denials and unresolved claims resolution; knowledge of ICD-10, CPT, HCPCS, and CMS-1500 claim format. Soft Skills: Critical thinker with strong problem-solving skills; high attention to detail; excellent organization and time management; ability to prioritize and manage time-sensitive situations with urgency.
Clinical Documentation Integrity Specialist (Hybrid - Portland, OR) Adventist HealthClinical Documentation Integrity Specialist (Hybrid - Portland, OR)Portland, ORReviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Clinical Documentation Integrity Specialist (Hybrid - Portland, OR) Adventist Health SystemClinical Documentation Integrity Specialist (Hybrid - Portland, OR)Portland, ORJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Senior Forward Deployed Engineer, ServiceNow Deloitte Touche Tohmatsu LtdSenior Forward Deployed Engineer, ServiceNowPortland, OR$155,600–$306,800 / yearDemonstrated use of Claude Code to accelerate delivery, including agentic multi-file workstreams, CLAUDE.md project memory, MCP server integrations, and parallel subagents for concurrent work such as feature development, test generation, and security review. At Deloitte, Forward Deployed Engineers (FDE) don't just build AI solutions, they help clients turn AI ambition into enterprise-scale impact, pairing leading class engineering with pod-based delivery and vertical expertise.
Certified Medical Coder Feed My People Food BankCertified Medical CoderPortland, OregonRemoteAfter work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.
Senior Forward Deployed Engineer, Servicenow DeloitteSenior Forward Deployed Engineer, ServicenowPortland, OR$155,600–$306,800 / yearDemonstrated use of Claude Code to accelerate delivery, including agentic multi-file workstreams, CLAUDE.md project memory, MCP server integrations, and parallel subagents for concurrent work such as feature development, test generation, and security review. At Deloitte, Forward Deployed Engineers (FDE) don't just build AI solutions, they help clients turn AI ambition into enterprise-scale impact, pairing leading class engineering with pod-based delivery and vertical expertise.
NewCustomer Service Representative - APPEARNCE CTR OR Providence Health & ServicesCustomer Service Representative - APPEARNCE CTR ORPortland, ORRequsition ID: 455081 Company: Providence Jobs Job Category: Customer Service Job Function: Administration Job Schedule: Part time Job Shift: Day Career Track: Admin Support Department: 5015 APPEARNCE CTR OR PSVMC Address: OR Portland 9205 SW Barnes Rd Work Location: Providence St Vincent Medical Ctr-Portland Workplace Type: On-site Pay Range: $21.16 - $32.37 Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Revenue Assurance Specialist IV - CDM and Epic experience needed Kaiser PermanenteRevenue Assurance Specialist IV - CDM and Epic experience neededPortland, ORPerforms routine review and maintenance of system codes by: performing a regular review (e.g., quarterly, annually) of coding records to ensure codes are updated, compliant, and accurately reflect policy and regulatory changes; conducting pre- and post-implementation assessments of automated and manual charge capture for quality and accuracy; analyzing moderately complex billing issues related to charges/codes and proposing and implementing action plans to resolve charge capture issues; and contributing to the maintenance of all Current Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) codes, descriptions, revenue codes, Relative Value Units (RVU) information, and generic codes to assist in the understanding of fee schedule implications. Executes monitoring activities and process improvements by: independently performing tasks that support monitoring activities of the region(s) documentation, charge capture, coding, billing, and/or compliance activities; recording findings in accordance with relevant policies/procedures to ensure complete and consistent data integrity, partnering with other departments to resolve moderately complex deficiencies and/or compliance issues identified through monitoring activities; communicating results of monitoring activities to senior team members and/or department leaders; and implementing corrective action plans resulting from monitoring activities.
NewSenior Data Scientist - Clinical Informatics (Analytics Enablement) CVS Health CorpSenior Data Scientist - Clinical Informatics (Analytics Enablement)OR$83,430–$222,480 / yearExperience designing patient-centric data models, feature stores, and dashboards that aggregate longitudinal data across sources, including demographics, encounters, conditions, medications, labs, utilization, cost, and enrichment attributes. A&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses.
Certified Nurse Midwife Women's Healthcare Associates LLCCertified Nurse MidwifePortland, ORBe close (within 90 minutes close) to our stunning coastal beaches; Columbia Gorge hiking; Mount Hood skiing; Willamette Valley wine country; and all the craft brews, farm-to-table, maker culture, urban-neighborhood or suburban-community charm you can dream of enjoying. As a CNM at WHA, you'll have a seamless, parallel partnership with our OB/GYN physicians, a voice at the table as a respected clinician and leader and the full support of our team of specialists-including maternal-fetal medicine, advanced gynecology and perinatal mental health.
Obstetrician/Gynecologist Provider Solutions & DevelopmentObstetrician/GynecologistPortland, ORBe close (less than 90 minutes) to our stunning coastal beaches; Columbia Gorge hiking; Mount Hood skiing; Willamette Valley wine country; and all the craft brews, farm-to-table, maker culture, urban-neighborhood charm you can dream of enjoying. Our clinicians love working here because of the passion our whole team brings to the job and to fulfilling our purpose-and the importance we place on recognizing the role every person has in delivering excellent care and an excellent care experience.
Patient Access Representative United Surgical Partners International Inc (USPI)Patient Access RepresentativePortland, ORFull timeEast Portland Surgery Center is one of Portland’s leading multi-specialty surgery centers, performing cases in pain management, GI, general surgery, orthopedics, urology, plastics, ophthalmology, gynecology, ENT & Spine. This position provides cross-functional support to business office operations and performs additional duties as assigned by the Business Office Manager to promote the efficient and effective operation of the ambulatory surgery center.
Medical Director - ENT CVS Health CorpMedical Director - ENTOR$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Payer Audit Specialist BrightSpring Health ServicesPayer Audit SpecialistVancouver, WA$20–$21 / hourThe Payer Audit Specialist performs quality assurance checks of all medical and billing documentation before submission and notifies the Revenue Cycle Management (RCM) Ancillary Services management team or General Manager of any missing items, issues, or trends. Ensures daily accomplishments by working toward individual and company goals for cash collections, payer audits, credit balances, medical records, correspondence, appeals/disputes, accounts receivable over 90 days, and other departmental goals.
Medical Claims Processor I Moda HealthMedical Claims Processor IMilwaukie, OR$17.34–$19.41 / hourResponsible 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. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.