Claims Rep - Public Adjusting Services | Flexible Hours Metro Public AdjustmentClaims Rep - Public Adjusting Services | Flexible HoursPortland, OR$50,000–$75,000 / yearFull timePart timeAfter registering, contact Senior Vice President, Stan Mason to confirm your interview: Email: smason@metropa.com. Local Opportunities – Serve homeowners across Philadelphia, Bucks County, Montgomery County, and nearby parts of South Jersey.
NewPharmacy Technician - Infusion Providence Non-RN - OregonPharmacy Technician - InfusionHillsboro, OR$23.81–$36.44 / hourSee Providence Health and Services Terms & Conditions at https://www.providence.org/utility-pages/privacy-policy#terms-of-use and Privacy Policy at https://www.providence.org/utility-pages/privacy-policy#privacy-policy and SonicJobs Privacy Policy at https://www.sonicjobs.com/privacy and Terms of Use at https://www.sonicjobs.com/terms. Our service lines include assisted living/skilled nursing/rehabilitation, home health, home infusion/pharmacy services, home medical equipment, hospice and palliative care, Program of All-Inclusive Care for the Elderly (PACE), personal home services/private duty care and supportive housing.
Claims 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.
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.
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.
NewClaims - FNOL (CCT) - Mgr Claims FNOL The Hanover Insurance Group IncClaims - FNOL (CCT) - Mgr Claims FNOLPortland, ORWork with employees on performance management by setting cascading goals, giving and receiving feedback, documenting and delivering performance reviews, addressing performance issues, creating and implementing development plans while conforming to policies and other internal procedures. POSITION OVERVIEW: Responsible for daily oversight of the unit, manage and lead team of employees, and build a highly engaged workforce to achieve the key business strategies of the organization through effective call center claims processing.
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, ORDetermines amounts owed, evaluates settlement value, negotiates with plaintiff counsel and other parties, and authorizes settlements and payments within assigned authority; recommends or issues denials when appropriate. The Claims Specialist works within a Claims Team, using the latest technology to manage a caseload of commercial rideshare, also known as Transportation Network Company (TNC), claims from initial investigation through resolution.
Senior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistOR$18.50–$42.35 / hourOur 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. Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.
Medical Claims Entry Operator Moda Partners IncMedical Claims Entry OperatorMilwaukie, OR$17.34–$18.92 / hourFor more information regarding accommodations please direct your questions to Kristy Nehler and 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.
Pharmacy Claims Review Manager Consonus PharmacyPharmacy Claims Review ManagerPortland, OregonFull timeThe Pharmacy Claims Manager partners closely with Billing, Customer Accounts, and Pharmacy Operations to ensure accurate reimbursement and compliance, minimize claim write-offs, and ensure exceptional service to residents, facilities, and payers. As the Pharmacy Claims Review Manager your responsibilities will include (but are not limited to): The Pharmacy Claims Manager is responsible for overseeing all pharmacy claims processing operations, including prescription adjudication, third-party billing, claim rejection management, and reimbursement optimization.
Medical Claims Entry Operator Moda HealthMedical Claims Entry OperatorMilwaukie, OR$17.34–$18.92 / hourFor more information regarding accommodations please direct your questions to Kristy Nehler and 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.
Field Claims Representative - Portland, Oregon Acuity, A Mutual Insurance CompanyField Claims Representative - Portland, OregonPortland, OR$75,000–$150,000 / yearMaintains working relationship with field sales force and underwriting department in securing and giving information on claims and regarding the risk desirability of insureds. The representative evaluates liability, exposure, subrogation potential and arrange for the disposition of claims through settlement or denial, including litigation.
Claims Supervisor II - Commercial Auto - BI Philadelphia Insurance CompaniesClaims Supervisor II - Commercial Auto - BIWest Linn, OR$114,408–$148,058 / yearSummary: Supervises claims adjusters and technical support staff to manage the day-to-day handling and settlement of claims, the processing and tracking of documents, making payments, tracking trends and communicating with underwriting. 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.
WFRP Claims Specialist Sompo International Holdings LimitedWFRP Claims SpecialistOR$70,000–$90,000 / yearThe employee is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices; and/or assembly or fabrication parts at distances close to the eyes. As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States.
Claims Specialist-WC Crawford & CoClaims Specialist-WCPortland, ORTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
Field Property Claims Adjuster: Portland, OR Farmers Group, Inc.Field Property Claims Adjuster: Portland, ORPortland, ORRemoteExposure to some or all of the following environments when in the field: Uncontrolled outside environmental conditions, Excessive noise levels, Chemicals Chemical/Biological conditions, Moving mechanical parts, Areas considered dangerous, Conditions which could affect the respiratory system or skin such as fumes, odors, dust, mists, gases, oils, smoke, soot, or poor ventilation. A Day in the Life of a Field Property Adjuster: Conduct both virtual and on-site investigations by visiting policyholders' residences to assess propertydamage, determine liability, evaluate the extent of loss, and negotiate fair settlements.
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.
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.
NewClaims Associate II J2 BUILDING CONSULTANTS INCClaims Associate IIPortland, OR$98,000–$135,000 / yearWhat Were Looking For: 7+ years of experience specifically in contracting or insurance related claims analysis Experience testifying as an expert witness or providing litigation support in 10 or more matters Advanced knowledge of building science, construction methods, and failure analysis Exceptional technical writing and communication skills, including presenting to executives, clients, and legal parties Ability to independently investigate, conclude, and defend findings Strategic thinker with strong problem-solving and decision-making skills Bachelors degree preferred in Engineering, Architecture, Building Science, or related field (equivalent experience considered). What Success Looks Like in This Role You: Reach sound technical conclusions independently, without needing sign-off Present confidently to executives, attorneys, and legal parties Are trusted to lead the most complex or high-stakes matters Mentor and elevate the technical capability of the team around you Actively grow the firms claims and expert consulting business.
RN Hospital Claims Auditor Moda HealthRN Hospital Claims AuditorPortland, OR$78,911.43–$98,639.28 / yearCollaborate with other Moda areas to provide clinical policy representation at meetings to ensure that decisions which affect claim processing are appropriate and will result in cost effective, efficient, and accurate claims payment. Assist with specific claim reviews such as diagnosis-related group (DRG) validation, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team.