NewClaims Adjuster Epitec, IncClaims AdjusterPortland, ORThis role requires strong analytical, communication, and decision-making skills to evaluate claims, determine liability, negotiate settlements, and ensure timely claim resolution while maintaining compliance with applicable policies and regulations. Conduct thorough investigations by gathering facts, interviewing claimants, insureds, witnesses, attorneys, medical providers, and other relevant parties.
NewClaims Processor Zenith American SolutionsClaims ProcessorPortland, OregonWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
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.
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.
Medical Claims COB Processor I Moda HealthMedical Claims COB Processor IMilwaukie, OR$18.39–$20.58 / hourAssists in customer service inquiries regarding contractual and administrative policies and applies excellent customer service when a phone call is needed to complete a COB claim. Minimum of 6 months medical claim processing or customer service dealing with all types of plans/claims and consistently exceeding performance levels.
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.
NonIT - Claim and Benefits Processor 2 Veterans Sourcing GroupNonIT - Claim and Benefits Processor 2Salem, ORRemoteThe main function of the Benefits Processor is to analyze disability claim information, make benefit decisions and payments on lower liability claims; administer low maintenance claims; provide administrative support for the department's management of disability claims including the set-up and distribution of new claims; provide responsive customer service to claimants, policyowners, Benefits staff, and group offices. •Investigate, secure and analyze information pertaining to claimant's medical condition, insured status and other policy provisions to accurately determine eligibility for, and entitlement to disability benefits for low liability and short duration claims; identify, file/fact discrepancies and outstanding issues and secure additional documentation as needed while investigating within prescribed time frames.
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.
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.
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.
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.
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.
Non-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote) Allstate Insurance CompanyNon-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote)ORRemote$47,500–$61,600 / yearCase Management, Claims Administration, Claims Resolution, Claims Review, Customer Centricity, Customer Service, Digital Literacy, Inclusive Leadership, Insurance Claims Investigations, Learning Agility, Personal Injury Claims, Problem Solving, Results-Oriented, Time Management, Written Communication. As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment.
Claims Manager MWHClaims ManagerSalem, OR$125,000–$160,000 / yearIncorporating industry-leading preconstruction and construction services, the Company’s multi-disciplined team of engineering and construction professionals delivers a wide range of projects, including new facilities, infrastructure improvement and expansion, and capital construction services. With the ultimate goal of delivering maximum value to clients and their local communities, MWH Constructors provides single-source, integrated design and construction services through a full range of project delivery methods.
Claims Supervisor Samaritan Health ServicesClaims SupervisorCorvallis, ORRemoteSamaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. KNOWLEDGE/SKILLS/ABILITIES Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures.
Claims Manager Slayden Constructors IncClaims ManagerSalem, OR$125,000–$160,000 / yearIncorporating industry-leading preconstruction and construction services, the Companys multi-disciplined team of engineering and construction professionals delivers a wide range of projects, including new facilities, infrastructure improvement and expansion, and capital construction services. This role involves coordinating with Legal & Risk, project teams, insurance carriers, legal counsel, and subcontractors with oversight from Director of Risk to mitigate risk, analyze claims, and protect the companys interests.
Claims Adjuster - Attorney Represented Injury The Progressive CorpClaims Adjuster - Attorney Represented InjuryTigard, OR$69,400–$89,800 / yearAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/.
Claims Adjuster Trainee The Progressive CorpClaims Adjuster TraineeTigard, OR$59,500–$63,500 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://www.progressive.com/careers/how-we-hire/faq/job-scams/ . This is a hybrid role, which means you'll work in-office two days that are selected by local leadership and choose where you want to work the other three days, whether that's at home or in the office, for a period of 12 months.
Financial Services Claims Adjuster Assurant IncFinancial Services Claims AdjusterOR$19.08–$30.53 / hourA Fortune 500 company with a presence in 21 countries, Assurant supports the advancement of the connected world by partnering with the world's leading brands to develop innovative solutions and deliver an enhanced customer experience through mobile device solutions, extended service contracts, vehicle protection services, renters insurance, lender-placed insurance products, and other specialty products. Named a Best/Great Place to Work in 14 countries and awarded the Fortune America's Most Innovative Companies recognition, we bring together top talent around the world.
Claims 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.
Stop Loss Claims Analyst CVS Health CorpStop Loss Claims AnalystOR$18.50–$35.29 / hourThis role involves preparing, tracking, reconciling, and helping generate and marshal stop loss filings to completion while serving as a key liaison across internal business partners, external stakeholders, and stop loss carriers. The position offers exposure to many areas of healthcare claims administration, including stop loss and reinsurance policy, data analytics, underwriting, eligibility, finance, client management, and provider and broker relations.
Claims Team Leader GT Independence CareersClaims Team LeaderSalem, OregonThe Claims Team Leader manages the submission of claims data, payments and works with team members and agencies to resolve outstanding claim issues. · Communicate with Claims Manager including but not limited to: training issues, agency challenges, unbilled items and A/R issues.
WC 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 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.
Senior Claims Manager, Remote - CA Workers'''' Compensation Great American Insurance CompanySenior Claims Manager, Remote - CA Workers'''' CompensationORRemote$135,000–$145,000 / yeargain buy-in from our insureds regarding the direction each claim is taking, develop a strategy of how to best mitigate the potential loss through interaction with the claimant, and making sure that light duty jobs are available for quick return to work. We need someone who has the ability to help and direct when needed, a group of strong, carefully chosen senior level adjusters to: focus on fresh, creative, and quick approaches on every claim resulting in proactive claim resolutions.
Veterans Claims Specialist Douglas County Developmental Disabilities ServicesVeterans Claims SpecialistRoseburg, OR$23.90–$31.52 / hourIndependently research, compile and summarize information for a variety of reports or to address, resolve issues or problems; prepare information for inclusion into reports; provide project and program management as assigned, which includes coordination with other agencies. Presence of non-prescribed drugs, including marijuana, on drug screen results will result in disqualification pursuant to the Countys drug and alcohol policy.
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.
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.
NewClaims Examiner - 4 Sunrise Systems IncClaims Examiner - 4Portland, ORStrong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses. Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
NewClaims Examiner-4 Sunrise Systems IncClaims Examiner-4Portland, ORStrong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses. Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
NewClaims Adjuster 4 ICONMA, LLCClaims Adjuster 4Portland, CA$16.50–$45.32 / hourStrong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses. Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Contracting Specialist Benefits and Claims Umpqua HealthContracting Specialist Benefits and ClaimsRoseburg, ORFull timeActing as the primary liaison between Umpqua Health and the TPA, this role drives accountability, resolves claims issues, and supports organizational goals for quality and efficiency. About Umpqua Health At Umpqua Health, we’re more than a healthcare organization—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon.
Contracting Specialist Benefits and Claims UMPQUA HEALTHContracting Specialist Benefits and ClaimsRoseburg, OR$84,000–$95,900 / yearActing as the primary liaison between Umpqua Health and the TPA, this role drives accountability, resolves claims issues, and supports organizational goals for quality and efficiency. At Umpqua Health, we're more than a healthcare organization-we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon.
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.
ESIS 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.
Senior Claims Specialist - WA and OR Jurisdiction Experience Liberty Mutual Holding Company IncSenior Claims Specialist - WA and OR Jurisdiction ExperienceLake Oswego, ORResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss.
NewClaims 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.
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).
Medical Claims Clerk I Moda HealthMedical Claims Clerk IMilwaukie, ORScan 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 Adjuster Trainee Allstate Insurance CompanyClaims Adjuster TraineeORAs a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Claims Adjuster Senior - Litigation The Progressive CorpClaims Adjuster Senior - LitigationTigard, OR$70,000–$90,000 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadEugene, OR$81,500–$108,000 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . As a claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve large-loss injury claims valued over $60k.
Claims Adjuster Senior - Injury The Progressive CorpClaims Adjuster Senior - InjurySalem, OR$70,000–$90,000 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.
Associate Claims Adjuster, Workers Compensation Liberty Mutual Holding Company IncAssociate Claims Adjuster, Workers CompensationORAs an Associate Claims Adjuster, you will develop the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.
Technical Claims Specialist Liberty Mutual Holding Company IncTechnical Claims SpecialistLake Oswego, ORResponsibilities: Investigates claims to determine whether coverage is provided; includes analysis of potentially applicable policy provisions and drafting comprehensive coverage position letters, sometimes in conjunction with Home Office Legal coverage counsel. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role.
Senior Claims Specialist I, Workers Compensation - West Region Liberty Mutual Holding Company IncSenior Claims Specialist I, Workers Compensation - West RegionLake Oswego, ORRemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state s tort laws as normally acquired through a bachelor s degree (or equivalent training) plus 3 to 5 years directly related work experience.
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 - 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.