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Claims Manager Jobs in Sandy, OR (NOW HIRING)

Aston Carter

Claims Assistant

Portland, OR · On-site

$22/hr

Provide administrative support to the Claims Manager and Claims Specialist, including documentation, tracking, and communication tasks. * Direct claims that exceed assigned authority to the Claims ...

Aston Carter

Claims Assistant

Happy Valley, OR · On-site +1

$19.75 - $25/hr

Provide administrative support to the Claims Manager and Claims Specialist, including documentation, tracking, and communication tasks. * Direct claims that exceed assigned authority to the Claims ...

Moda Health

Supervisor, Medical Claims

Milwaukie, OR · Remote

$59K - $74K/yr

Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems. * Controls workflow and ...

Chubb

ESIS Senior Claims Representative, WC

Portland, OR · On-site

$78K - $109K/yr

Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. As a ...

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Claims Manager information

See Sandy, OR salary details

$36.8K

$92.3K

$146.1K

How much do claims manager jobs pay per year?

As of Aug 11, 2026, the average yearly pay for claims manager in Sandy, OR is $92,334.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,500.00 and $110,300.00 per year, depending on experience, location, and employer.

How much do claims managers make in the US?

Claims managers in the US typically earn a median annual salary of around $80,000 to $100,000, with experienced professionals and those in senior roles earning higher. Salaries can vary based on location, industry, and level of experience, and many claims managers hold certifications such as the Chartered Property Casualty Underwriter (CPCU).

What is the difference between Claims Manager vs Claims Adjuster?

AspectClaims ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree, industry certifications (e.g., CPCU), and management experienceUsually requires a high school diploma or bachelor’s degree, with certifications like AIC or CPCU preferred
Work EnvironmentOversees claims departments, manages teams, and develops policies within insurance companiesEvaluates individual claims, investigates damages, and determines settlement amounts
Employer & Industry UsageCommonly employed in insurance companies, handling claims processes and team managementFound in insurance firms, adjusting claims directly with policyholders and providers

In summary, Claims Managers oversee the claims process and manage teams, requiring leadership skills and industry certifications. Claims Adjusters focus on evaluating individual claims, investigating damages, and determining payouts. Both roles are essential in the insurance industry but differ in scope and responsibilities.

What is the role of a claims manager?

A claims manager oversees the processing and settlement of insurance claims, ensuring accuracy and compliance with policies. They evaluate claim validity, coordinate with adjusters and clients, and may use claims management software to streamline operations.

How does a claims manager balance high case volumes with thorough and accurate claim assessments?

Claims Managers often face the challenge of managing a large number of claims while maintaining quality and compliance. To address this, they implement efficient workflows, delegate tasks among team members, and use claims management software to automate routine processes. Regular team meetings and performance tracking help ensure that each claim is processed accurately and within regulatory timelines. Strong organizational skills and effective communication are key to balancing these demands and supporting both claimants and internal stakeholders.

What skills and qualifications are needed to be a claims manager?

To thrive as a Claims Manager, you need expertise in insurance policies, risk assessment, and claims processing, usually supported by a degree in business, finance, or a related field. Familiarity with claims management software, regulatory compliance tools, and industry certifications such as AIC (Associate in Claims) is typically required. Strong analytical thinking, negotiation skills, and effective communication help you manage complex cases and lead teams successfully. These skills and qualities are vital for ensuring accurate claims resolution, minimizing financial loss, and maintaining client trust.

What does a claims manager do?

A Claims Manager oversees the processing and resolution of insurance claims within an organization. Their responsibilities include evaluating claims, ensuring compliance with company policies and legal regulations, and managing a team of claims adjusters or examiners. Claims Managers work to ensure claims are handled efficiently and fairly, often acting as a point of escalation for complex or disputed cases. They also analyze data to improve claims processes and mitigate risk. Effective communication and leadership skills are essential in this role.
More about Claims Manager jobs
What are popular job titles related to Claims Manager jobs in Sandy, OR? For Claims Manager jobs in Sandy, OR, the most frequently searched job titles are:
What cities near Sandy, OR are hiring for Claims Manager jobs? Cities near Sandy, OR with the most Claims Manager job openings:
Claims Manager jobs near you
Infographic showing various Claims Manager job openings in Sandy, OR as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 14% Part Time, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $92,334 per year, or $44.4 per hour.

Pharmacy Claims Review Manager

Consonus Pharmacy

Portland, OR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 27 days ago

Job description

Overview
Pharmacy Claims Manager
What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe working with a supportive team is top priority, or to feel respected and valued.
If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being.
Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers. We are currently hiring a Pharmacy Claims Manager to join our team!
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. This position leads a team responsible for ensuring accurate and timely claim submission, resolution of claim exceptions, compliance with PBM, Medicare Part D, Medicaid, and commercial payer requirements, and adherence to NCPDP standards.
The 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. In our Long-Term Care environment, there is focus on coordination with the Credentialing & Contracting team on payer enrollment issues, and management of LTC-specific reject queues related to transition fills, hospice billing, and facility census changes.
Some benefits may include:
  • Paid training & career advancement opportunities
  • $25,000 toward ongoing education benefit
  • Generous Paid Time Off that pools vacation, sick & holiday pay in a single bucket for flexible use
  • Medical/Dental/Vision insurance
  • Free access to MDLIVE - allowing access to your health benefits from anywhere
  • 401K With Employer Match
  • Employee Assistance Program: with free access to counseling & support services

Qualifications
  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field; equivalent experience considered.
  • Minimum 5 years of pharmacy claims, third-party billing, pharmacy revenue cycle, or PBM operations experience. Long - Term Care experience preferred.
  • Minimum 2 years of supervisory or management experience.
  • Strong understanding of: NCPDP claim standards, Medicare Part D, Medicaid pharmacy billing, Managed Care reimbursement, PBM claim adjudication processes, Pharmacy revenue cycle operations.
  • Experience working with PBMs such as Express Scripts, CVS Caremark, OptumRx, Humana, Prime Therapeutics, MedImpact, and Navitus.
  • Experience managing Medicare Part D, Medicaid, and dual-eligible populations
  • Advanced analytical and problem-solving skills.
  • Proficiency with pharmacy management systems and reporting tools
  • Ability to work under pressure in fast-paced environment ensuring timely and accurate billing
  • Ability to travel to other pharmacy locations as required
  • Certified Pharmacy Technician (CPhT) preferred (can obtain after hire)

EEO Statement
"Be here. Be you."
For more than 30 years, Marquis Companies and Consonus Healthcare have been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We've continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy.
We're committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis and Consonus. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives.
That means you being you - without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It's the foundation of who we are and the evolution of our collective future.

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