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Medical Claims Jobs in Remote, OR (NOW HIRING)

Bluespine-Sr. FWA Analyst

OR ยท On-site +1

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 ...

Pharmacy Biller

Coos Bay, OR

$17.25 - $22.25/hr

This role reviews claims, resolves denials, and supports patients with billing and insurance ... Working knowledge of pharmacy or medical billing terminology and coding standards (e.g. NCPDP ...

Billing Specialist

Roseburg, OR ยท On-site

$23.12 - $30.70/hr

This position is responsible for prompt, accurate, and effective medical insurance claim submission, with follow-up of claims to satisfactory resolution. ESSENTIAL FUNCTIONS: * Review medical ...

Billing Specialist

Roseburg, OR ยท On-site

$23.12 - $30.70/hr

This position is responsible for prompt, accurate, and effective medical insurance claim submission, with follow-up of claims to satisfactory resolution. ESSENTIAL FUNCTIONS: * Review medical ...

Billing Specialist

Roseburg, OR ยท On-site

$23.12 - $30.70/hr

This position is responsible for prompt, accurate, and effective medical insurance claim submission, with follow-up of claims to satisfactory resolution. ESSENTIAL FUNCTIONS: * Review medical ...

... claims Benefits Available: * Paid Time Off and 9 Paid Holidays * 401k * Uniforms/Scrubs Provided * Continuing Education * Malpractice Insurance * Employee Referral Program Bonuses * Medical, Dental ...

... claims Benefits Available: * Paid Time Off and 9 Paid Holidays * 401k * Uniforms/Scrubs Provided * Continuing Education * Malpractice Insurance * Employee Referral Program Bonuses * Medical, Dental ...

... no negative claims Compensation Range 200,000 to 320,000 Benefits Available Benefits Available ... Medical, Dental, and Vision Insurance * Company-Paid Life, Short-Term and Long-Term Disability ...

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Medical Claims information

See Remote, OR salary details

$5

$16

$18

How much do medical claims jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for medical claims in Remote, OR is $16.81, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $18.27 per hour, depending on experience, location, and employer.

What are medical claims?

Medical claims are formal requests submitted by healthcare providers or patients to insurance companies, asking for payment for medical services rendered. These claims contain detailed information about the patient, the services provided, dates of service, and relevant medical codes. Insurance companies review the claims to determine coverage and reimburse providers or patients accordingly. Accurate and timely submission of medical claims is crucial to ensure proper payment and avoid delays or denials.

What are the key skills and qualifications needed to thrive as a medical claims specialist?

To thrive as a Medical Claims Specialist, you need knowledge of medical terminology, insurance policies, and claims processing, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health records (EHRs), and billing systems such as ICD-10 and CPT coding is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve claim discrepancies. These skills are crucial for ensuring timely and accurate claims processing, minimizing errors, and maintaining compliance with healthcare regulations.

What are some common challenges faced in a medical claims role, and how can they be effectively managed?

Medical claims professionals often encounter challenges such as handling denied or complex claims, navigating frequent regulatory changes, and communicating with both patients and insurance providers. Staying updated with the latest healthcare regulations and payer requirements is essential to minimize claim rejections. Effective time management, attention to detail, and strong communication skills help resolve issues quickly and ensure accurate processing. Collaborating closely with billing teams and healthcare providers also aids in addressing discrepancies and expediting claim approvals.

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

AspectMedical ClaimsMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies and coding; certifications like CPC or CCS are commonRequires similar certifications; focuses on billing processes and insurance claims
Work EnvironmentHealthcare facilities, insurance companies, billing companiesMedical offices, hospitals, billing companies
Job FocusSubmitting and managing insurance claims for reimbursementPreparing and sending bills to patients and insurers, managing accounts

Medical Claims specialists primarily handle the submission and management of insurance claims to ensure healthcare providers receive payment. Medical Billing Specialists focus on creating and sending bills to patients and insurance companies, managing payments, and maintaining billing records. While both roles require knowledge of insurance processes and coding, Medical Claims roles are more centered on claims submission and follow-up, whereas Medical Billing Specialists handle the overall billing process and patient invoicing.

Is medical claims processing a stressful job?

Medical claims processing can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often involves detailed data entry, familiarity with insurance policies, and sometimes dealing with frustrated clients, which can contribute to stress levels. However, workload and stress vary depending on the employer and individual workload management skills.

What are the most commonly searched types of Medical Claims jobs in Remote, OR?

The most popular types of Medical Claims jobs in Remote, OR are:

Infographic showing various Medical Claims 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 $34,965 per year, or $16.8 per hour.

Bluespine-Sr. FWA Analyst

Team8

OR โ€ข On-site, Remote

Full-time

Re-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.