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Medical Claims Processing Jobs in Portland, OR (NOW HIRING)

Moda Health

Medical Claims Entry Operator

Milwaukie, OR

$17.34 - $18.92/hr

Position Summary Enters the processing system all claims received by mail or route claims as ... Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ...

Moda Health

Medical Claims Processor I

Milwaukie, OR · Hybrid

$17.34 - $19.41/hr

Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ... claims processing as well as providing suggestions for potential process improvements. * Performs ...

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/claims and consistently exceeding performance levels. * Professional and effective written and verbal ...

Moda Health

Supervisor, Medical Claims

Milwaukie, OR · Remote

$59K - $74K/yr

Provides supervision, coaching and support to Claims Processors. Organizes staff, sets goals ... Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ...

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 ... Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ...

Zenith American Solutions, Inc.

Claims Processor

Tualatin, OR · On-site

$17.75 - $22.50/hr

Six months of experience processing health and welfare claims. * Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 ...

Zenith American Solutions, Inc.

Claims Processor

Tualatin, OR · On-site

$17.75 - $22.50/hr

Six months of experience processing health and welfare claims. * Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 ...

Zenith American Solutions, Inc.

Claims Processor

Tualatin, OR · On-site

$17.75 - $22.50/hr

Six months of experience processing health and welfare claims. * Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 ...

Zenith American Solutions, Inc.

Claims Processor

Tualatin, OR · On-site

$17.75 - $22.50/hr

Six months of experience processing health and welfare claims. * Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 ...

Zenith American Solutions

Claims Processor

Tualatin, OR · On-site

$17.75 - $22.50/hr

Six months of experience processing health and welfare claims. * Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 ...

Moda Health

Provider Correspond Coord I

Milwaukie, OR · On-site +1

$19.43 - $21.86/hr

High School education or equivalency. * 6 months - 2 years' medical claims processing or customer service experience. * Strong reading, writing and verbal communication skills * Good analytical ...

Western Partitions

Claims Assistant

Wilsonville, OR · On-site

$19.50 - $24.50/hr

Claims Assistant Western Partitions, Inc. (WPI) is one of the largest and most reputable interior ... Familiarity with workers' compensation claim documentation, Return to Work processes, medical work ...

Western Partitions, Inc.

Claims Assistant

Wilsonville, OR

$19.50 - $24.50/hr

Claims Assistant Western Partitions, Inc. (WPI) is one of the largest and most reputable interior ... Familiarity with workers' compensation claim documentation, Return to Work processes, medical work ...

Western Partitions, Inc.

Claims Assistant

Wilsonville, OR · On-site

$19.50 - $24.50/hr

Claims Assistant Western Partitions, Inc. (WPI) is one of the largest and most reputable interior ... Familiarity with workers' compensation claim documentation, Return to Work processes, medical work ...

Western Partitions, Inc.

Claims Assistant

Wilsonville, OR · On-site

$19.50 - $24.50/hr

Claims Assistant Western Partitions, Inc. (WPI) is one of the largest and most reputable interior ... Familiarity with workers' compensation claim documentation, Return to Work processes, medical work ...

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All JobsMedical Claims Processing JobsMedical Claims Processing Jobs in Portland, OR

Medical Claims Processing information

See Portland, OR salary details

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$27

How much do medical claims processing jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for medical claims processing in Portland, OR is $20.65, according to ZipRecruiter salary data. Most workers in this role earn between $18.37 and $22.93 per hour, depending on experience, location, and employer.

What is medical claims processing?

Medical claims processing is the administrative procedure of reviewing, validating, and handling healthcare claims submitted by providers to insurance companies or payers for reimbursement. This process involves checking the accuracy of the submitted information, verifying patient eligibility and coverage, and ensuring that services are medically necessary and properly coded. Claims processors work to approve, deny, or request additional information to resolve claims, ultimately ensuring that healthcare providers receive payment and patients are billed accurately.

What are some common challenges faced in medical claims processing, and how can professionals address them?

Medical claims processors often encounter challenges such as handling complex insurance policies, navigating frequent regulatory changes, and ensuring the accuracy of coding and billing information. To address these issues, professionals need to stay updated with industry regulations, maintain strong attention to detail, and communicate effectively with healthcare providers and insurance companies. Ongoing training and the use of specialized software can also help streamline workflows and minimize errors, making the process more efficient.

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

To thrive as a Medical Claims Processor, you need a solid understanding of medical terminology, insurance policies, and claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, healthcare coding systems (ICD-10, CPT), and electronic health record (EHR) systems is typically required. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and timely processing. These skills are crucial for minimizing errors, reducing claim denials, and supporting efficient healthcare reimbursement processes.

What is the difference between Medical Claims Processing vs Medical Billing?

AspectMedical Claims ProcessingMedical Billing
CredentialsTypically requires knowledge of insurance policies and claims proceduresRequires understanding of coding and billing practices
Work EnvironmentOften in insurance companies, healthcare providers, or claims processing centersPrimarily in healthcare provider offices or billing companies
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsHospitals, clinics, medical practices, billing services

Medical Claims Processing focuses on reviewing and submitting insurance claims for reimbursement, ensuring compliance with policies. Medical Billing involves coding patient services and generating bills for patients and insurers. While related, Claims Processing emphasizes claim review and approval, whereas Billing centers on creating accurate invoices for services rendered.

Do you need a degree to be a medical claims processor?

A degree is not typically required to become a medical claims processor, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, knowledge of medical billing and coding, and familiarity with claims processing software; certifications such as CPC or CPC-H can enhance job prospects.

How to get a job as a medical claims processor?

To become a medical claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certification in medical billing and coding. Relevant skills include attention to detail, knowledge of insurance policies, and proficiency with claims processing software; certifications like Certified Professional Coder (CPC) can improve job prospects. Entry-level positions often require basic computer skills and understanding of healthcare terminology, with on-the-job training provided for specific systems used by employers.

What are popular job titles related to Medical Claims Processing jobs in Portland, OR?

For Medical Claims Processing jobs in Portland, OR, the most frequently searched job titles are:

What job categories do people searching Medical Claims Processing jobs in Portland, OR look for?

The top searched job categories for Medical Claims Processing jobs in Portland, OR are:

What cities near Portland, OR are hiring for Medical Claims Processing jobs?

Cities near Portland, OR with the most Medical Claims Processing job openings:

Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in Portland, OR as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $42,943 per year, or $20.6 per hour.

Medical Claims Entry Operator

Moda Health

Milwaukie, OR

$17.34 - $18.92/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Moda Health rating

8.5

Company rating: 8.5 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

110th of 315 rated insurance

Job description

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.


Position Summary
Enters the processing system all claims received by mail or route claims as directed to processing specific data entry queues.  Interrogates data on claims received electronically where member or provider information does not match Moda records. This is a FT WFH role. 
Pay Range
$17.34 - $18.92 hourly (depending on experience) *Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.


Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27782855&refresh=true
Benefits:

  • Medical, Dental, Vision, Pharmacy, Life, & Disability
  • 401K- Matching
  • FSA
  • Employee Assistance Program
  • PTO and Company Paid Holidays

Required Skills, Experience & Education:

  • High school diploma or equivalent.
  • Six months data entry experience.
  • 10-key proficiency of 135 spm net on a computer numeric keypad.
  • Typing ability of 35 wpm net.
  • Proficiency with Microsoft Office applications and an understanding of basic claims processing rules.
  • Strong problem solving and detail orientation skills.
  • Medical terminology helpful.
  • Ability to adapt to frequent changes in instructions.
  • Ability to come into work on time and on a daily basis.
  • Maintain confidentiality and project a professional business image.


Primary Functions:

  • Data enters claims accurately using Moda computer systems. Reassigns claims appropriately as outlined by Medical Claims processing guidelines. 
  • Resolves claims that pend with errors in the processing system by matching claims received to Moda providers or member records.
  • Research and problem solve basic claims data.
  • Identifies and communicates trends.
  • Performs other duties as assigned.


Working Conditions & Contact with Others

  • Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week, including evenings and occasional weekends, to meet business need.
  • Internally with Membership Accounting, Medical Claims, and Professional Relations.
     

Together, we can be more. We can be better.
 ​​​​​​
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. 
For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email.

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