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

Team8

Bluespine-Sr. FWA Analyst

OR · On-site +1

... medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, regulatory agency ...

CONFEDERATED TRIBES OF CLUSI

Pharmacy Biller

Coos Bay, OR

$17.25 - $22.25/hr

... timely processing of pharmacy billing and reimbursement activities. This role reviews claims ... Working knowledge of pharmacy or medical billing terminology and coding standards (e.g. NCPDP ...

Aviva Health

Billing Specialist

Roseburg, OR · On-site

$23.12 - $30.70/hr

Identify accounts which may require a refund and process appropriately. * Manage claims through various online tools and reporting systems. * Identify education needs for providers and medical staff ...

New

Aviva Health

Billing Specialist

Roseburg, OR

$23.12 - $30.70/hr

Identify accounts which may require a refund and process appropriately. * Manage claims through various online tools and reporting systems. * Identify education needs for providers and medical staff ...

Aviva Health

Billing Specialist

Roseburg, OR · On-site

$23.12 - $30.70/hr

Identify accounts which may require a refund and process appropriately. * Manage claims through various online tools and reporting systems. * Identify education needs for providers and medical staff ...

Aviva Health

Billing Specialist

Roseburg, OR · On-site

Identify accounts which may require a refund and process appropriately. * Manage claims through various online tools and reporting systems. * Identify education needs for providers and medical staff ...

New

Therapeutic Associates

Authorization Representative

OR · On-site +1

$17 - $20/hr

... medical field are expected. Duties & Responsibilities: * Process, follow-up, and monitor all ... claims as needed. * Request additional information from clinic staff as necessary to complete ...

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Medical Claims Processing information

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$25

How much do medical claims processing jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for medical claims processing in Remote, OR is $19.45, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.63 per hour, depending on experience, location, and employer.

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 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 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.

How to become a medical claims processor?

To become a medical claims processor, candidates typically need a high school diploma or equivalent, along with training in medical billing and coding. Many employers prefer familiarity with claims processing software and knowledge of healthcare regulations, and some roles may require certification such as the Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS).

Is it hard to get hired as a medical biller?

Getting hired as a medical biller generally requires relevant training or certification, attention to detail, and familiarity with billing software and healthcare regulations. Job availability can vary based on location and experience, but entry-level positions are often accessible with proper skills and certifications such as CPC or CPC-A. Strong organizational skills and understanding of insurance processes improve employment prospects.

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 highest paying adjuster job?

The highest paying adjuster jobs are typically senior or specialized roles such as catastrophe or large-loss adjusters, who handle complex claims and often work for major insurance companies. These positions usually require extensive experience, industry certifications like the Chartered Property Casualty Underwriter (CPCU), and may involve working long hours or in high-stress environments.

What healthcare jobs pay over $100k per year?

In medical claims processing, senior roles such as Claims Manager or Director can earn over $100,000 annually, especially with extensive experience and certifications. Other high-paying healthcare jobs include physicians, surgeons, and specialized healthcare administrators, which often require advanced degrees and specialized skills.
What are popular job titles related to Medical Claims Processing jobs in Remote, OR? For Medical Claims Processing jobs in Remote, OR, the most frequently searched job titles are:
What job categories do people searching Medical Claims Processing jobs in Remote, OR look for? The top searched job categories for Medical Claims Processing jobs in Remote, OR are:
What cities near Remote, OR are hiring for Medical Claims Processing jobs? Cities near Remote, OR with the most Medical Claims Processing job openings:
Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in Remote, OR as of July 2026, with employment types broken down into 87% Full Time, 10% Part Time, and 3% Contract. Highlights an 79% Physical, 4% Hybrid, and 17% Remote job distribution, with an average salary of $40,453 per year, or $19.4 per hour.

Bluespine-Sr. FWA Analyst

Team8

OR • On-site, Remote

Full-time

Posted 5 days ago

Job description

Description
Bluespine is an innovative new startup in the health-IT domain. By employing cutting-edge technologies, Bluespine is developing an engine that detects errors in medical billing, which causes billions of dollars in losses across the entire industry. Bluespine can offer personalized precision by tailoring assessments to each unique medical claim, considering the relevant provider, payer, and plan, and ensuring unparalleled accuracy.
We are looking for a Sr. FWA Analyst experienced in discovering medical billing errors and fraudulent billing patterns of medical claims for commercial payers.
Responsibilities
  • Proactively identify potential instances of fraud, waste, and abuse through data analysis using company systems and tools
  • Support engineering and data science teams with audit and FWA concepts, data mapping, and defining data requirements
  • Determine the likelihood of cases being true error/fraud, based on real-life experience.
  • Validate and help to tune anomaly detection algorithms.

Requirements
  • Hands-on experience exploring and investigating potential medical billing errors/fraud using analytic and SQL/graph-based tools.
  • Extensive knowledge of medical terminology, medical records, health information management, medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, regulatory agency policies (CMS/HCFA, DOI, state regulations), and provider billing systems and practices.
  • Strong analytical skills and ability to approach tasks in a scientific manner.
  • Background in SIU or Payment Integrity.
  • Independent, Organized, and with excellent communication skills.

Advantages
  • Medical/clinical background.
  • Experience with Pharma claims.
  • Billing/coding experience.

Apply