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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 ...

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

$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 ...

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Medical Claims Processing information

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$13

$19

$25

How much do medical claims processing jobs pay per hour?

As of Sep 3, 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 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 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 August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, and 5% Contract. Highlights an 71% Physical, 1% Hybrid, and 28% 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

Re-posted 14 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.

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