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Insurance Claims Processing Jobs in Oregon (NOW HIRING)

Point C

OR · On-site

At least 2+ years of experience in insurance claims processing required * Experience reviewing and finalizing claim payments for accuracy in accordance with plan policies * Ability to interpret and ...

AllCare Health

Certified Claims Processor I

Grants Pass, OR · On-site

$16.50 - $21/hr

This role applies coding knowledge and established claims processing standards to resolve standard ... Coordinates benefits by reviewing member eligibility, other insurance information, and payer ...

Standard, The

Supplemental Claims Examiner

Portland, OR · On-site

Job Summary This role is responsible for adjudicating and processing supplemental insurance claims from intake through final payment. The position focuses on gathering and analyzing claim information ...

Moda Health

Medical Claims COB Processor I

Milwaukie, OR · Remote

$18.39 - $20.58/hr

Minimum of 6 months medical claim processing or customer service dealing with all types of plans ... Communicates via telephone with claimants, policyholders, providers, and other insurance carriers.

Corvel

Claims Specialist

Portland, OR · Remote

$52K - $85K/yr

... process taking into consideration experience, qualifications, and overall fit for the role. The ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Corvel

Claims Specialist

$52K - $85K/yr

... process taking into consideration experience, qualifications, and overall fit for the role. The ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Liberty Mutual

Claims Specialist

Lake Oswego, OR

Assesses 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 ...

Liberty Mutual

Claims Specialist

Lake Oswego, OR

$101K/yr

Assesses 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 ...

Stcharles

Temporary Insurance Follow-up Specialist

OR · Remote

$22.30 - $30.11/hr

Insurance Follow-up and Denials Specialist 1 REPORTS TO POSITION: Claims Supervisor DEPARTMENT ... Submit corrected claims. Process late charges using the late charge functionality. Generate and ...

Stcharles

Temporary Insurance Follow-up Specialist

OR · Remote

$22.30 - $30.11/hr

Insurance Follow-up and Denials Specialist 1 REPORTS TO POSITION: Claims Supervisor DEPARTMENT ... Submit corrected claims. Process late charges using the late charge functionality. Generate and ...

Liberty Mutual

Assesses 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 ...

Liberty Mutual

Assesses 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 ...

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Insurance Claims Processing information

Is claims processing a stressful job?

Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires strong attention to detail, communication skills, and the ability to handle difficult or emotional situations with claimants. However, workload and stress levels can vary depending on the employer and specific job environment.

What is insurance claims processing?

Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.

What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?

In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.

How to get a job as a claims adjuster with no experience?

To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license, which is often required. Gaining entry-level positions or internships in insurance companies can also help build industry knowledge and skills like communication and attention to detail, increasing your chances of starting a claims adjusting career.

What is the difference between Insurance Claims Processing vs Insurance Adjuster?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing damages and determining claim validity and payout

While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.

What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?

To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.

What does an insurance claims processor do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using specialized software. Strong attention to detail and knowledge of insurance policies are essential for this role.
What are popular job titles related to Insurance Claims Processing jobs in Oregon? For Insurance Claims Processing jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Oregon look for? The top searched job categories for Insurance Claims Processing jobs in Oregon are:
What cities in Oregon are hiring for Insurance Claims Processing jobs? Cities in Oregon with the most Insurance Claims Processing job openings:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Oregon as of July 2026, with employment types broken down into 92% Full Time, 6% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution.
Claims Examiner

Claims Examiner

Point C

OR • On-site

Other

Posted 16 days ago

Job description

Point C is looking for a detail-oriented and motivated Claims Examinerto join our team. In this role, you'll be responsible for accurately processing medical claims while ensuring compliance with plan documents, policies, and industry regulations. The ideal candidate is analytical, organized, and experienced in self-funded or third-party administration environments.

Primary Responsibilities:

  • Adjudicate new claims and process adjustments, including denials upon receipt of additional information
  • Review and resolve appeals and subrogation/third-party liability cases
  • Manage individual inventory to ensure timely turnaround and production goals are met
  • Ensure claims are processed in accordance with stop loss contract terms
  • Respond to internal and external inquiries via email and other channels within established timeframes
  • Follow up on missing or incomplete information to ensure claims can be accurately processed
  • Maintain minimum production, financial, and procedural accuracy standards on a monthly basis

Qualifications:

  • Experience with Third Party Administrator (TPA) or self-funded claims administration preferred
  • At least 2+ years of experience in insurance claims processing required
  • Experience reviewing and finalizing claim payments for accuracy in accordance with plan policies
  • Ability to interpret and apply plan documents to ensure accurate claims adjudication
  • Demonstrated understanding of both claim review processes and underlying benefit plan design
  • Experience with HealthPac, El Dorado, Javelina, or VBA systems preferred
  • Working knowledge of CPT and ICD-10 coding
  • Basic understanding of medical terminology
  • Strong communication and customer service skills
  • Proficiency in Microsoft Office and general computer applications
  • Ability to maintain confidentiality and comply with all company policies and procedures
  • Able to work independently with minimal supervision
  • Ability to prioritize, multitask, and work overtime as needed
  • Associate Degree Preferred

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