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Insurance Appeals Jobs in Oregon (NOW HIRING)

CERiS

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Corvel

Appeals Representative II

$18.80 - $30.34/hr

The Appeals Representative is responsible for addressing provider inquiries and appeals via email ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Curana Health, Inc.

Experience within Medicare Advantage health insurance, including appeals, grievances, customer service, and complaint resolution. * Working knowledge of Medicare Advantage regulations, appeals ...

LearnWell

$45K - $48K/yr

The ideal candidate for the position will have extensive experience in various aspects of medical billing, including but not limited to claim submissions, prior authorizations, insurance appeals, and ...

Centene

Remote Medical Director, Appeals

OR · On-site +1

$236K - $449K/yr

Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy ... Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel ...

Kairos

Insurance Coordinator

Grants Pass, OR

... appeals Client & Team Support * Provide clear, compassionate explanation of insurance benefits to clients * Support clinicians and scheduling staff with insurance-related questions * Maintain ...

Kairos

Insurance Coordinator

Grants Pass, OR · On-site

... appeals Client & Team Support * Provide clear, compassionate explanation of insurance benefits to clients * Support clinicians and scheduling staff with insurance-related questions * Maintain ...

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Insurance Appeals information

What are the key skills and qualifications needed to thrive in insurance appeals?

To thrive in Insurance Appeals, you need a solid understanding of insurance policies, claims processes, medical terminology, and relevant regulations, often supported by experience in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHRs), and knowledge of HIPAA compliance are typically required. Strong analytical skills, attention to detail, and effective written and verbal communication set outstanding professionals apart. These skills are crucial for efficiently navigating complex appeals, ensuring compliance, and achieving positive outcomes for clients or organizations.

What are some common challenges faced in an insurance appeals role, and how can they be managed?

Professionals in Insurance Appeals often encounter challenges such as navigating complex policy guidelines, handling tight deadlines, and managing extensive documentation requirements. Staying organized and up-to-date on insurance regulations is essential to ensure accurate and timely submissions. Collaborating closely with medical providers, patients, and insurance representatives can help clarify information and strengthen appeal cases. Effective time management and clear communication are key to overcoming these challenges and achieving successful outcomes.

What are insurance appeals?

Insurance appeals are formal requests made to an insurance company to reconsider and potentially overturn a denied claim or coverage decision. When an insurance provider refuses to pay for a service or treatment, policyholders or healthcare providers can submit an appeal with supporting documentation to argue why the claim should be approved. The appeals process typically involves several steps and may require detailed medical records, letters from healthcare professionals, and a clear explanation of why the original decision should be reversed.
What are popular job titles related to Insurance Appeals jobs in Oregon? For Insurance Appeals jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Insurance Appeals jobs in Oregon look for? The top searched job categories for Insurance Appeals jobs in Oregon are:
Insurance Appeals jobs near you
Infographic showing various Insurance Appeals job openings in Oregon as of August 2026, with employment types broken down into 80% Full Time, and 20% Part Time. Highlights an 87% In-person, 4% Hybrid, and 9% Remote job distribution.

Appeals Representative II

CERiS

Remote

$18.80 - $30.34/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 11 days ago

Job description

The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions.

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Reviews, analyzes, and completes appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication
  • Ability to appropriately interpret provider appeals and apply analytical thinking skills
  • Ability to interpret client policy and CMS guidelines as it relates to reviews done by CERiS such as itemized bill
  • Utilize applicable tools and resources to complete appeals
  • Timely completion of appeals
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Prior knowledge of inpatient and outpatient hospital revenue cycle required
  • Excellent written and verbal communication skills
  • Contract interpretation, medical terminology and coding knowledge
  • Proficiency with Microsoft applications

EDUCATION & EXPERIENCE:

  • High school diploma or equivalent
  • 3+ years of healthcare revenue cycle experience (collections, appeals, denials management, etc)
  • 2+ years working with customers in a fastpaced, deadlineoriented environment
  • 2+ years experience as an Appeals Representative
  • Strong attention to detail, organizational and time management skills with the ability to
  • interpret, research and identify core issues
  • Strong customer focus, analytical and decision making skills
  • Strong technical skills with the ability to work across multiple software systems and comfortable work remote out of your home

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  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.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $18.80 - $30.34 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CERiS:

CERiS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote

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About CERIS

Sourced by ZipRecruiter

Industry

Health care and social assistance

Company size

51 - 200 Employees

Headquarters location

Fort Worth, TX, US

Year founded

1990

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