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Insurance Claims Processing Jobs in Oregon (NOW HIRING)

First American

Claims Advocate Specialist

OR · On-site +1

$20.34 - $27.12/hr

Investigating, analyzing and responding to highly complex claims from escalated to management ... and process payment requests * Piloting innovative company initiatives Requirements: * Bachelors ...

The US Oncology Network

Insurance Specialist

Eugene, OR · On-site

$21 - $34/hr

Insurance Billing is a difficult field, and this position is compounded by the complexities of ... Demonstrate knowledge of state, federal, and third-party claims processing required. * Demonstrate ...

Allcat Claims Service

Claims Examiner

OR · On-site +1

All claim will be reviewed and approved in line within current Standard Flood Insurance Policy ... Enjoys working in a fast-paced environment and easily acclimates to changes in process/systems for ...

Dabella

Finance Processor

Hillsboro, OR

$22 - $24/hr

... processing financial data from sales representatives while managing diverse administrative and ... Company Sponsored Life Insurance * Supplemental Life Insurance * Long-term and short-term ...

Moda Health

Lead Medical Claims Auditor I

Milwaukie, OR · On-site

$20.88 - $23.49/hr

... of process improvements. Oversees department workflow and provides assignments as needed. Assists ... Externally with Providers, Members, Vendors, Insurance companies, Reinsurance carriers, Case ...

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Insurance Claims Processing information

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 the key skills and qualifications needed to thrive in insurance claims processing?

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 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.

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.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certifications in insurance or claims processing. Relevant skills include attention to detail, communication, and familiarity with claims management software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require background checks or specific licensing depending on the state or company policies.

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

What does an insurance claims processing 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 claims management software. 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 August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 23% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Manager of Claims (Health Plans)

Samaritan Health Services

Corvallis, OR • Remote

Full-time

Posted 4 days ago

Samaritan Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

495th of 898 rated healthcare providers

Job description

  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

    As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

    This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

  • JOB SUMMARY/PURPOSE

    • Oversees and manages the Samaritan Health Plans Claims Department. Is responsible for accurate and timely claims processing for all programs administered by Samaritan Health Plans. Provides oversight to staff and ensures that the organization's performance expectations, financial standards, and goals are achieved. Enhances department bench strength by hiring, coaching and mentoring direct reports. Responsible for the completion and success of all internal and external claims audits. Analyzes claims data and ensures compliance requirements are met. 

  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor's degree in healthcare or a related field, or equivalent direct claims experience required.
    • Three (3) years management experience in a health plan claims department required.
    • Experience or training in the following required:
      • Collecting, analyzing and displaying statistical reports by computerized technology.
      • Basic medical terminology.
    •  
      Medicare and/or Medicaid experience preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
  •  
  • PHYSICAL DEMANDS

    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      LIFT (Floor to Waist: 0"-36") 0-20 Lbs
       

      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
       

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
      CARRY 1-handed, 0 - 20 pounds
       

      CARRY 2-handed, 0 - 20 pounds
       

      KNEEL (on knees)
       

      BEND FORWARD at waist
       

      CLIMB - STAIRS

      STAND
       

      WALK - LEVEL SURFACE
       

      ROTATE TRUNK Standing
       

      REACH - Upward
       

      PUSH (0-20 pounds force)
       

      PULL (0-20 pounds force)

      SIT
       

      ROTATE TRUNK Sitting
       

      REACH - Forward
       

      MANUAL DEXTERITY Hands/wrists
       

      FINGER DEXTERITY
       

      PINCH Fingers
       

      GRASP Hand/Fist

      None specified

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