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Medical Claim Analyst Jobs in Oregon (NOW HIRING)

Bluespine can offer personalized precision by tailoring assessments to each unique medical claim ... We are looking for a Sr. FWA Analyst experienced in discovering medical billing errors and ...

Minimum of 6 months medical claim processing or customer service dealing with all types of plans ... Good analytical, problem solving, decision making and detail-oriented skills with ability to shift ...

Requests reports and records, and reviews medical bills, mail and wage statements * Prints and ... ANALYTICAL THINKING: Ability to analyze and compare information to understand issues and explore ...

New

RN Hospital Claims Auditor

Portland, OR · On-site +1

$78K - $98K/yr

Perform pre and post pay medical claim reviews utilizing itemized hospital bills and other ... integrity analytical team. * Document review findings for processing staff and prepare written ...

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Medical Claim Analyst information

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How much do medical claim analyst jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medical claim analyst in Oregon is $26.55, according to ZipRecruiter salary data. Most workers in this role earn between $20.34 and $26.68 per hour, depending on experience, location, and employer.

What does a medical claim analyst do?

A Medical Claim Analyst reviews and processes medical insurance claims submitted by healthcare providers or policyholders. They examine the accuracy and completeness of the claims, verify patient eligibility and coverage, and ensure that the services billed are covered by the insurance policy. Medical Claim Analysts also identify potential errors, discrepancies, or fraudulent activities in claims and communicate with providers or members to resolve issues. Their work helps ensure timely and accurate reimbursement for medical services and maintains the integrity of the claims process.

What are the key skills and qualifications needed to thrive as a medical claim analyst, and why are they important?

To thrive as a Medical Claim Analyst, you need a solid understanding of medical terminology, insurance guidelines, and claims processing, often supported by a relevant associate degree or certification. Familiarity with claims management software, ICD-10/CPT coding systems, and electronic health record (EHR) platforms is typically required. Strong attention to detail, analytical thinking, and effective communication skills help analysts resolve discrepancies and collaborate with healthcare providers. These skills ensure accurate claim evaluations, minimize errors, and contribute to efficient reimbursement processes in healthcare organizations.

What are some common challenges medical claim analysts face when reviewing complex claims?

Medical Claim Analysts often encounter challenges such as interpreting varying coding standards, handling incomplete or ambiguous documentation, and staying updated with constantly changing healthcare regulations. Managing high volumes of claims while ensuring accuracy can also be demanding, especially when claims involve specialized procedures or multi-layered insurance policies. Strong attention to detail, effective communication with providers or patients, and ongoing training help analysts overcome these obstacles and ensure timely, accurate claim processing.

What is the difference between Medical Claim Analyst vs Medical Billing Specialist?

AspectMedical Claim AnalystMedical Billing Specialist
CredentialsTypically requires a certification like CPC or similarOften requires certification but less specialized
Work EnvironmentInsurance companies, healthcare providers, or third-party payersMedical offices, clinics, or billing companies
Job FocusAnalyzing and processing insurance claims, ensuring accuracyPreparing and submitting patient bills, following up on payments

While both roles involve handling healthcare financial transactions, Medical Claim Analysts focus on reviewing and processing insurance claims for accuracy and reimbursement, whereas Medical Billing Specialists primarily prepare and submit patient bills and follow up on payments. Both roles require knowledge of medical coding and insurance policies but differ in their core responsibilities and work settings.

How much do medical claim analysts make in the US?

Medical claim analysts in the US typically earn a median annual salary of around $45,000 to $65,000, depending on experience, location, and certifications. Entry-level positions may start lower, while experienced analysts or those with specialized skills can earn higher salaries, often with opportunities for overtime and bonuses.

How to become a medical claim analyst?

To become a medical claim analyst, typically a high school diploma or equivalent is required, with many employers preferring a bachelor's degree in health administration, finance, or a related field. Relevant skills include knowledge of insurance policies, medical billing, and claims processing software, and some positions may require certification such as the Certified Professional Coder (CPC) or similar credentials.

What is the role of a Medical Claim Analyst?

A Medical Claim Analyst reviews and processes healthcare insurance claims to ensure accuracy, compliance, and proper reimbursement. They analyze medical records, verify billing details, and work with insurance providers to resolve claim discrepancies, often using claims processing software and requiring knowledge of healthcare regulations.

What job categories do people searching Medical Claim Analyst jobs in Oregon look for?

The top searched job categories for Medical Claim Analyst jobs in Oregon are:

Infographic showing various Medical Claim Analyst job openings in Oregon as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 18% Part Time, and 6% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $55,229 per year, or $26.6 per hour.

Claims Analyst I (Analyst I - CPPW)

City of Portland

Portland, OR • On-site, Remote

$40.97 - $58.47/hr

Full-time

Posted 15 days ago


City Of Portland (Oregon) rating

9.1

Company rating: 9.1 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

77th of 856 rated public administrative organizations


Job description

The Position Job Appointment: Full Time, Regular Work Schedule: Monday - Friday, 8:00 AM - 5:00 PM. Alternate schedules may be available. Work Location: Fully Remote.

Remote work must be performed within Oregon or Washington. For more information, click here. Union Representation: City of Portland Professional Workers Union (CPPW).

To view current labor agreements, click here. Starting Pay: The City of Portland follows the Oregon Equal Pay Act. Your salary is determined based on the experience listed in your resume that is directly related and equivalent to the position for which you are applying.

Position Summary: The Claims Analyst is part of the Risk Management Division within the Office of the Chief Financial Officer. Risk Management administers the City's self-insured general liability and workers' compensation programs, procures commercial insurance for property and other risks, and supports City bureaus with employee safety, loss prevention, risk assessment, and third-party subrogation. The Claims Analyst is responsible for investigating, evaluating, managing, and resolving a variety of claims involving the City and its employees.

Claims may include general liability, auto liability, law enforcement liability, employment practices tort claims, and federal claims involving alleged constitutional violations. The successful candidate will help minimize the City's financial exposure through thorough investigations, thoughtful claim evaluation, effective negotiation, accurate documentation, and sound professional judgment. This position requires the ability to independently manage a caseload while working collaboratively with claimants, attorneys, City employees, bureau leadership, and other stakeholders.

Claims Analysts are expected to exercise initiative, independence, discretion, and sound legal and professional judgment when evaluating claims and determining appropriate courses of action. What You'll Do: Investigate claims by interviewing involved parties, obtaining statements, reviewing records, conducting research, and gathering information necessary to determine the City's potential liability. Conduct site inspections and document accident or incident scenes when appropriate.

Evaluate repair estimates, invoices, medical information, and other documentation supporting claimed damages. Identify and investigate potential third-party liability and opportunities for recovery or subrogation. Determine whether City employees were acting within the course and scope of their employment and coordinate indemnification and defense when appropriate.

Evaluate liability and damages by applying applicable laws, defenses, immunities, comparative negligence principles, tort limitations, and other relevant considerations. Establish and maintain appropriate claim reserves within established authority levels and guidelines. Negotiate and resolve claims with claimants, attorneys, insurers, and other representatives, including issuing timely settlements or denials when appropriate.

Monitor litigated claims and help forecast and control litigation expenses and potential damage awards throughout the life of the claim. Collect, evaluate, and maintain accurate claims data within the City's Risk Management Information System (RMIS) to support tracking, forecasting, analysis, and reporting. Maintain organized, accurate, complete, and current electronic claim files and documentation.

Communicate claim analyses, recommendations, and decisions to City staff, attorneys, management, elected officials, claimants, and other stakeholders. Ideal Candidate Profile: The ideal candidate is an experienced claims professional who can independently investigate complex situations, analyze competing information, apply applicable laws and policies, and make well-supported decisions. They are comfortable handling sensitive and sometimes contentious matters while maintaining professionalism, objectivity, confidentiality, and excellent customer service.

To Qualify Applicants must demonstrate how their education, training, and experience meet each of the minimum qualifications listed below: Experience investigating, evaluating, and resolving general liability and auto liability claims. Experience applying laws, regulations, and legal principles affecting potential liability, exposure, or settlement limitations, including comparative negligence, immunities, defenses, Medicare reimbursement requirements, and tort claim limitations. Experience applying best practices for managing electronic claim files and records, including using online research tools, claims data or risk management information systems, and Microsoft Office applications.

Ability to communicate effectively verbally and in writing regarding sensitive or complex matters and provide clear claim analyses, evaluations, and recommendations to a variety of audiences, such as claimants, attorneys, City management, external partners, and elected officials. Ability to understand, interpret, explain, and apply complex laws, rules, regulations, policies, and procedures; prepare clear, concise, and accurate reports and correspondence; and represent an organization authoritatively when negotiating claim settlements. Experience establishing and maintaining effective working relationships with diverse internal and external stakeholders, such as employees, legal counsel, managers, claimants, members of the public, and others encountered in the course of claims administration.

Applicant must also possess: A valid state driver's license and acceptable driving record. Preferred Qualifications: Experience investigating and resolving public entity or governmental liability claims. Professional insurance or risk management designations such as Associate in Risk Management (ARM), Associate in Claims (AIC), or Casualty Claim Law Associate (CCLA).

Experience using Marsh ClearSight/Riskonnect or a comparable Risk Management Information System (RMIS). The Recruitment Process How to Apply: Submit your resume and cover letter by the closing date. (Optional) Submit Veterans' Preference documents, if applicable.

If this is your first time applying with the City of Portland, or if you haven't requested veteran preference before (and would like to now), please attach your DD214-Member 4 and/or VA Benefit Letter to your application. Once we verify your eligibility, we'll record your veteran preference in our system, so it automatically applies to your future applications. Click here for application tips for resume, supplemental question response and/or cover letter.

What to Expect: Application Review - Week of September 7, 2026: We'll review your application materials to ensure you meet the minimum qualifications listed above. Notice/Feedback - Week of September 14, 2026: You will receive an email when the minimum qualification review is complete. If you disagree with the evaluation results, you may request a review within 14 days of the email notice, per City Administrative Rule 3.01

Selection Process - Late September/Early October: The hiring bureau will review qualified applications, conduct interviews, and check references. Conditional Job Offer: Final candidates may undergo a background or driving record check, depending on the position. Additional Information Learn More About: How to Apply Videos and Workshops City of Portland Core Values HRAR-3.01 - Recruitment Processes Veteran Preference Information Total Compensation and Benefits Language Pay Differential Eligibility We're committed to providing a fair, inclusive, and accessible hiring process

If you need assistance with your application or would like to request a reasonable accommodation due toa disability, pregnancy, or religious belief, please contact the recruiter listed below. Questions. We're here to help.

If you have questions about this recruitment or need assistance, contact: Tamela Ressler, Senior Recruiter Tamela.Ressler@portlandoregon.gov Bureau of Human Resources.


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