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.
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.
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.
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.
Insurance Specialist - Billing/ Follow Up Compass OncologyInsurance Specialist - Billing/ Follow UpVancouver, WAFull timeAs a member of The US Oncology Network, one of the nation's largest community-based cancer treatment and research networks, Compass Oncology participates in leading-edge clinical trials through US Oncology research, which has helped develop 89 FDA approved cancer therapies. If you are a dedicated, team-oriented, patient-centered individual looking for an opportunity where you are proud of what you do, work hard, have fun, want to learn and go home at the end of the day knowing you made a difference in the lives of our patients; Compass Oncology is the place for you!
Pharmacy Program Manager Cambia Health SolutionsPharmacy Program ManagerVancouver, WAFull timeDeep knowledge of pharmacy benefit management, benefit design, pharmacy products and services, competitive offerings, and client needs, including advanced understanding of healthcare operations, cost containment strategies, provider contracting methodologies, and benefit design alternatives. As a member of the Pharmacy Services team, our Pharmacy Program Managers are responsible for partnering with clinical stakeholders to develop, execute, evaluate and maintain clinical programs and strategies to support cost containment and clinical quality improvements related to pharmacy.
Policy & Implementation Analyst or Sr. DOE Cambia Health SolutionsPolicy & Implementation Analyst or Sr. DOEVancouver, WAFull timeServes as primary support for CPT/HCPCS procedure and ICD-9/ICD-10 diagnosis coding questions across Cambia, ensuring decision-making related to coding is consistent, clinically appropriate and thoroughly documented. * Facilitates development, understanding and documentation of business requirements related to policy implementation, clinical editing, and reimbursement policy development including issue identification, research, approval, implementation, documentation and education.
Spv Business Support Services Cambia Health SolutionsSpv Business Support ServicesVancouver, WAFull timeThis includes support of global configuration, incident resolution, conversion activities, enhancement design, developing general and detailed functional and business requirements, testing, project work, and support in the production environments. This includes scoping and resources planning for any projects related to configuration and support of any Facets system, any associated extension or interface that interacts with Facets, along with all legacy membership systems.
Business Systems Analyst Support Services Lead Cambia Health SolutionsBusiness Systems Analyst Support Services LeadVancouver, WAFull timeAs a member of the Customer Experience and Operations team, our Business Systems Analyst Support Services Lead participates in the daily support, maintenance, and enhancement of existing systems, as well as the development, configuration, and delivery of new systems to directly support Cambia Core Strategies and Key Initiatives - all in service of economically sustainable health care system. * Demonstrated ability to develop project plans and schedules to ensure all tasks are identified and completed, and assigns tasks and workflow as necessary for completion, including the ability to support and answer questions from Level I team members.
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.
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 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.
Claims And Risk Manager Brown & Brown, INC.Claims 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.
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 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.
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.
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 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.
NewESIS Claims Representative, WC Chubb LtdESIS Claims Representative, WCPortland, OR$62,700–$81,300 / 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 industry's broadest selections of risk management solutions covering both pre- and post-loss services.
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.
Claims Adjuster Epitec StaffingClaims AdjusterPortland, OR$47–$52 / 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.
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).
NewSenior Personal Property Claims Adjuster - Field USAASenior Personal Property Claims Adjuster - FieldPortland, OR$63,590–$121,530 / yearApplies proficient knowledge of estimating technology platforms and virtual inspection tools; Utilizes platforms and tools to prepare claims estimates to manage moderate complexity property insurance claims. What you'll do: Proactively manages assigned claims caseload comprised of claims with moderate complexity damages that require commensurate knowledge and understanding of claims coverage.
Claims Assistant CorVel CorpClaims AssistantPortland, ORRemote$15.05–$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!).
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.
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/ .
NewProperty Claims Adjuster Specialist - Field USAAProperty Claims Adjuster Specialist - FieldPortland, OR$69,920–$133,620 / yearWhat you'll do: Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Claims Adjuster 4 Iconma LLCClaims Adjuster 4Portland, CAStrong 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.
NewCommercial Senior Auto Claims Adjuster- Remote CSAA Insurance GroupCommercial Senior Auto Claims Adjuster- RemoteORRemote$27.55–$30.61 / hourAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 19 more}. Most employees hold Home-Flex roles, working primarily from home, often with the flexibility to work from various locations including Mobilitas offices.
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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.
Claims Consultant, Life Sciences CNA Financial CorpClaims Consultant, Life SciencesPortland, OR$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims with large exposures that require a high degree of 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 complex manage litigation and authorizing payments within scope of authority.
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.