Medical Claims Clerk I Moda HealthMedical Claims Clerk IMilwaukie, OR$19.43–$21.86 / hourScan and index mail using designated printers and software, and prepare documents for submission to Imaging according to established workflows. Manage assigned Content Manager image queues and work baskets and prioritize tasks based on urgency, service levels, and departmental guidelines.
Claims Examiner/Member Services Representative United Employers Association and its AffiliatesClaims Examiner/Member Services RepresentativePortland, ORFull timeSmall Health and Welfare Claims Administrator seeks full-time Claims Examiner/Member Services Representative to process claims and provide outstanding customer service to external and internal clients. Successful candidate must be detail oriented, possess excellent interpersonal skills, be a master communicator, and demonstrate a strong desire to assist others and continuously learn.
Claims Specialist CorVel Enterprise Claims, Inc.Claims SpecialistPortland, ORRemote$52,999–$85,473 / yearPart timeThe Workers’ CompensationClaims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Claims Supervisor CorVel Enterprise Claims, Inc.Claims SupervisorPortland, ORRemote$73,345–$113,247 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Supervisor, Healthcare Services Claims Moda Partners IncSupervisor, Healthcare Services ClaimsPortland, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
Supervisor Workers Comp Claims - PNW CopperPoint Insurance CoSupervisor Workers Comp Claims - PNWPortland, ORRemote$105,000–$135,000 / yearThe majority of the supervision for this team is currently Alaska and Idaho workers' compensation claims- experience is a must for AK, and candidate must be willing and able to quickly learn ID jurisdiction and obtain licensure if no prior experience with ID claims. Develops and maintains partnerships and service level agreements with leaders within other divisions to ensure processes and workflows are effective, and customer service goals are being met.
Sr. Claims Specialist - Commercial Auto BI Philadelphia Insurance CompaniesSr. Claims Specialist - Commercial Auto BIWest Linn, OR$102,150–$120,177 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
WC Claims Consultant Alera Group IncWC Claims ConsultantPortland, OR$80,000–$110,000 / yearParticipate with or without Sales Executives in presentations to current clients, prospects, proposals, and RFP presentations. Provide assistance to clients seeking to enhance their return-to-work programs and light duty return to work opportunities.
Claims Specialist - Auto Philadelphia Insurance CompaniesClaims Specialist - AutoWest Linn, OR$82,800–$97,300 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Associate - Workers Comp. AvenicaClaims Associate - Workers Comp.Portland, ORContact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to secure necessary claim information. Our customer is a financially stable, nationally recognized employer of choice with offices in major U.S. cities and a strong track record of developing early-career talent.
National Litigation & Claims Management Attorney AttorneysNational Litigation & Claims Management AttorneyPortland, OregonThe ideal candidate is not only experienced, but agile, someone who can quickly pivot between priorities, manage competing deadlines, and proactively identify risks and opportunities across a complex, multi-jurisdictional docket. We are seeking a highly skilled attorney with deep experience in litigation, claims management, and, critical discovery strategy and execution to support our representation of a large, national logistics services provider.
NewHybrid WC Claims Consultant: Risk & Advocacy Dickerson GroupHybrid WC Claims Consultant: Risk & AdvocacyPortland, OR$80,000–$110,000 / yearThe position offers a hybrid working arrangement, competitive salary between $80,000 and $110,000 annually, and comprehensive benefits.#J-18808-Ljbffr. Applicants should possess an Oregon or Washington Agent's License, with at least 5 years of experience in workers' compensation claims.
Sr. Adjuster-Workers Comp Claims CopperPoint Insurance CoSr. Adjuster-Workers Comp ClaimsORRemote$65,000–$120,000 / yearThe Workers' Compensation Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers' compensation claims to determine compensability. We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee's annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).
NewWC Claims Consultant Alera GroupWC Claims ConsultantPortland, OregonParticipate with or without Sales Executives in presentations to current clients, prospects, proposals, and RFP presentations. Provide assistance to clients seeking to enhance their return-to-work programs and light duty return to work opportunities.
Claims Director(WC & TPA Oversight) CNA Financial CorpClaims Director(WC & TPA Oversight)Portland, OR$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Leads the work activities of claims professionals and/or claims managers and has full management responsibility for setting and communicating expectations, providing direction and coaching, facilitating ongoing training and development, managing employee performance and contributing to employee engagement. This director-level role operates under general direction with broad authority to lead the oversight of complex, high-exposure commercial Workers' Compensation claims managed by Third-Party Administrators (TPAs), while also managing and developing a team of claim professionals.
Senior Claims Specialist - CA Workers'''' Compensation Great American Insurance CompanySenior Claims Specialist - CA Workers'''' CompensationOR$110,000–$120,000 / yearAlthough we typically require 10+ years of experience, we will consider exceptional candidates with 7+ years of proven success in California workers' compensation claims adjusting experience with higher exposure claims. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use.
Pharmacy Technician - Claims Review Consonus PharmacyPharmacy Technician - Claims ReviewPortland, OregonFull timeAs the Claims Review Specialis t, your responsibilities will include prior authorizations, answering questions regarding prior authorizations, apply for prior authorizations and communicate with facilities and physicians, work daily rejects, communication with internal departments. Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers.
Senior Claims Advocate HUB InternationalSenior Claims AdvocateLake Oswego, ORWe are the perfect fit if you: + are seeking a progressive work environment at a rapidly growing organization + have a desire to help others protect their future + have an entrepreneurial spirit and are challenged by the opportunity to grow the business + are focused on learning and development to enhance your industry knowledge and expertise + are a self-starter willing to invest time and energy to learn the technical aspects of our business + believe in integrity and building success by developing relationships with others **Here's Where You Come In** We are currently seeking a Senior Claims Advocate to join our growing Commercial Insurance Claims team. Our entrepreneurial culture fosters an environment that empowers our people to make the best decisions for our customers and organization, focusing on expanding the industry knowledge of our insurance professionals to better serve our valued clients.
NewClaims and Risk Manager Brown & Brown IncClaims and Risk ManagerPortland, ORThe Claims and Risk Manager develops and implements comprehensive risk management strategies, advocates for clients throughout the claims process, and collaborates with internal teams and external partners to ensure effective, compliant, and client-focused service delivery. Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role.
Property Field Claims Adjuster (Portland, OR) American Family Insurance GroupProperty Field Claims Adjuster (Portland, OR)Portland, OR$57,000–$94,000 / yearInvestigates origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc. This experience is held in person at our Madison, WI Headquarters or one of our AmFam core locations to help you connect with our mission, meet key team members and build relationships that support your growth.
Claims Specialist Maddox Industrial TransformerClaims SpecialistBattle Ground, WashingtonExperience in claims processing, investigations, dispute resolution, military service, law enforcement, account/project management, team leadership, or similar roles requiring independent judgment and decision-making. Maddox is the nation’s leading provider of electrical transformers to the commercial and industrial market, with primary locations in South Carolina, Washington State, Texas, Idaho, and Ohio.
ESIS Claims Representative, WC Chubb LtdESIS Claims Representative, WCPortland, OR$67,000–$83,000 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industrys broadest selections of risk management solutions covering both pre- and post-loss services.
ESIS Claims Associate Chubb LtdESIS Claims AssociatePortland, OR$47,500–$67,500 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OOR$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
NewNational Litigation & Claims Attorney - Remote/Hybrid BCG Attorney SearchNational Litigation & Claims Attorney - Remote/HybridPortland, ORRemoteBCG Attorney Search is seeking a National Litigation and Claims Management Attorney in Portland, Oregon, to support a large logistics services provider's legal representation. The ideal candidate will independently handle litigation caseloads, develop strategic discovery responses, and enhance a national claims program, all while collaborating with the legal team.
Supervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminPortland, ORRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Claims Recoup & Collect Anlyst TriWest Healthcare AllianceClaims Recoup & Collect AnlystPortland, ORRemoteFull timeUnder limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.
Claims Supervisor CorVel CorpClaims SupervisorPortland, ORRemote$73,345–$113,247 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Claims Specialist CorVel CorpClaims SpecialistPortland, ORRemote$52,999–$85,473 / yearThe Workers' Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Claims Assistant CorVel CorpClaims AssistantPortland, OR$16.90–$23.42 / hourPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
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.
Dental Claims Processor I Moda HealthDental Claims Processor IMILWAUKIE, OR$17.34–$18.36 / hourFor more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.
Lead Medical Claims Auditor I Moda HealthLead Medical Claims Auditor IMilwaukie, OR$20.88–$23.49 / hourStrong analytical, problem solving, and decision-making skills with demonstrated ability to handle and resolve complaints, correct errors, and resolve departmental issues in accordance with Moda contracts and company policies. Includes monitoring of assignments and overtime, evaluating performance, training, communicating policy to staff, and answering questions from Claims Auditors and Reinsurance Specialists.
Supervisor, Medical Claims Moda HealthSupervisor, Medical ClaimsMilwaukie, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
Supervisor, Healthcare Services Claims - Internal Applicants Only Moda HealthSupervisor, Healthcare Services Claims - Internal Applicants OnlyPortland, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
Medical Claims Auditor I Moda HealthMedical Claims Auditor IMilwaukie, OR$18.39–$20.58 / hourInternally with Claims, Sales & Account Services, Membership Accounting, Benefit Configuration, Information Services, Customer Service and Provider Relations. 6 months – 2 years claim processing or customer service dealing with all types of plans/claims consistently exceeding performance levels.
Inpatient Claims Processor I Moda HealthInpatient Claims Processor IMilwaukie, OR$21.30–$23.96 / hourReview, analyze, price, and resolve inpatient claims through the utilization of available resources for moderate to complex inpatient claims, adjustments, and file reviews. Works internally with Healthcare Services, Membership Accounting, Customer Service, Hospital Auditors, Provider Correspondence, and Professional Relations.
Workers Compensation - Sr Consultant Casualty Claims - Southwest The Hanover Insurance Group IncWorkers Compensation - Sr Consultant Casualty Claims - SouthwestPortland, ORCompensation: The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience. Individuals with disabilities who wish to request a reasonable accommodation to participate in the job application or interview process, or to perform essential job functions, should contact us at:HRServices@hanover.com and include the link of the job posting in which you are interested.
NewClaims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsPortland, Oregon$59,059.65–$82,000 / yearFull timeWith the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Escalation Rep TriWest Healthcare AllianceClaims Escalation RepPortland, ORRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.
Claims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterLake Oswego, ORAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
Claims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterORAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
NewESIS Senior Claims Representative, WC Chubb LtdESIS Senior Claims Representative, WCPortland, OR$71,000–$104,000 / yearWith more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
Claims Reviewer TriWest Healthcare AllianceClaims ReviewerPortland, ORRemoteFull timeProficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.
Workers Compensation Claims Examiner | SIP Required Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | SIP RequiredORRemote$80,000–$100,000 / yearPRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Senior Workers Compensation Claims Adjuster - OR/WA GallagherSenior Workers Compensation Claims Adjuster - OR/WAPortland, OregonRemoteFull timeAbout you : Ideal candidates for this position will have: • Claims Background: A minimum of 3-5 years experience handling lost time/indemnity claims and have extensive experience with litigated files • Jurisdictional Experience: OR, WA • Active Adjusters' licenses : OR, WA As a key member of our experienced Claims Adjuster team, you will: The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours.
Independent Insurance Claims Adjuster in West Linn, Oregon MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in West Linn, OregonWest Linn, OregonIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
NewIndependent Insurance Claims Adjuster in Vancouver, Washington MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Vancouver, WashingtonVancouver, WashingtonIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Oregon City, Oregon MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Oregon City, OregonOregon City, OregonIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Gresham, Oregon MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Gresham, OregonGresham, OregonIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.