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Remote Appeals Analyst Jobs in Oregon (NOW HIRING)

Centene

Clinical Appeals Coordinator

OR · On-site +1

$33.71 - $60.67/hr

Gather, analyze and report verbal and written information regarding member and provider clinical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

EnableComp

Resolution Analyst, Denials (REMOTE)

OR · On-site +1

Review, evaluate, appeal, and follow up on outstanding, denied, underpaid, and other assigned ... Strong analytical and problem-solving skills. * Proven experience working with external clients ...

Manulife

Senior Underwriting Consultant

OR · On-site +1

$98K - $116K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... The incumbent will analyze decisions without compromising overall underwriting policies and should ...

Deloitte

Epic Denials Management Operator

Portland, OR · Remote

$19 - $25.50/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Conduct Denial categorization and root cause analysis based on remittance information received from ...

Moda Health

Provider Correspond Coord I

Milwaukie, OR · On-site +1

$19.43 - $21.86/hr

Responds to provider appeals and related correspondence. * Interacts with physician/provider ... Good analytical, problem solving, decision making and organizational skills. * 10 key proficiency ...

Dmainc

Director, Property Tax

Portland, OR · Remote

... appeals and hearings with state and local taxing authorities. * Review and approve analyses that ... Frequent repetitive motions with hands #LI-JS1 #LI-REMOTE The Company is an equal employment ...

Wyndham Hotels & Resorts

Corporate Account Director

OR · On-site +1

Wyndham Hotels & Resorts is now seeking a Corporate Account Director to join our team at the Remote ... Analytical skills to understand reports and trends. * Understanding of metrics and goals and how to ...

Wyndham Hotels & Resorts

Corporate Account Director

Wyndham Hotels & Resorts is now seeking a Corporate Account Director to join our team at the Remote ... Analytical skills to understand reports and trends. * Understanding of metrics and goals and how to ...

Direct Counsel

Legal E-Billing Coordinator

Portland, OR · On-site +1

$90K - $105K/yr

Submit appeals or adjustments on short-paid invoices through client portals. * Assist in preparing ... Excellent communication, analytical, and problem-solving skills. * Meticulous attention to detail ...

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All JobsAppeals Analyst JobsRemote Appeals Analyst JobsRemote Appeals Analyst Jobs in Oregon

Remote Appeals Analyst information

What is a remote appeals analyst?

A Remote Appeals Analyst is a professional who reviews, processes, and evaluates insurance claims and appeals from a remote location, often working from home. Their role typically involves analyzing denied or disputed insurance claims, gathering relevant documentation, and determining whether appeals are justified based on policies and regulations. They communicate findings to insurance companies, healthcare providers, or clients, and may draft appeal letters or recommend further actions. Strong analytical, communication, and organizational skills are essential for this job, along with a good understanding of insurance policies and healthcare regulations.

What are the key skills and qualifications needed to thrive as a remote appeals analyst?

To thrive as a Remote Appeals Analyst, you need a solid understanding of healthcare claims processing, medical terminology, and insurance regulations, often supported by a relevant degree or prior experience in medical billing or claims review. Familiarity with claims management software, electronic health record (EHR) systems, and sometimes certification such as Certified Professional Coder (CPC) is typically required. Strong analytical thinking, attention to detail, and effective written communication skills help you clearly articulate appeals and resolve claim issues. These skills and qualifications are crucial for ensuring accurate and timely resolution of appeals, compliance with regulations, and maintaining positive payer relationships.

How does a remote appeals analyst typically collaborate with other departments while working remotely?

As a Remote Appeals Analyst, you’ll regularly collaborate with departments such as claims processing, customer service, and medical review teams through virtual meetings, email, and secure messaging platforms. Effective communication and organizational skills are crucial since you’ll often need to clarify details, gather documentation, and coordinate resolutions on appeal cases from a distance. Many organizations use workflow management software to streamline this collaboration, ensuring appeals are resolved efficiently while maintaining compliance and confidentiality.

What are popular job titles related to Remote Appeals Analyst jobs in Oregon?

For Remote Appeals Analyst jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Remote Appeals Analyst jobs in Oregon look for?

The top searched job categories for Remote Appeals Analyst jobs in Oregon are:

What cities in Oregon are hiring for Remote Appeals Analyst jobs?

Cities in Oregon with the most Remote Appeals Analyst job openings:

Remote Appeals Analyst jobs near you
Infographic showing various Remote Appeals Analyst job openings in Oregon as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Clinical Appeals Coordinator

Centene

OR • On-site, Remote

$33.71 - $60.67/hr

Full-time

Medical, Retirement, PTO

Posted 23 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

Position Purpose:
Act as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals. Responsible for ensuring that all appeal letters generated comply with both State and NCQA requirements.

Key Details: Must have an unencumbered RN, LVN or LPN license in the state of Oregon. This position will work Pacific Time Zone hours.

  • Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services requested.
  • Prepare reviews for cases that did not meet criteria
  • Gather, analyze and report verbal and written information regarding member and provider clinical appeals, including information follow up
  • Prepare response letters for member and provider clinical appeals and ensure letters are compliant with State and NCQA standards.
  • Maintain files and logs for all appeals
  • Coordinate with Medical Director(s) to clarify medical determinations or clinical rationale
  • Maintain current knowledge of NCQA and State regulations
  • Coordinate Fair Hearings with various internal departments and agencies
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience:
RN with 4+ years of clinical nursing and/or case management experience or LPN/LVN with 5+ years of clinical nursing or case management experience. Managed care or utilization review experience preferred.
License/Certification: LPN, LVN, or RN license.
Specialty Therapy Requirement: Master's degree in area of specialty therapy or equivalent experience. 3+ years of experience providing therapy services in healthcare or home health settings. Managed care or utilization review experience preferred.

Pay Range: $33.71 - $60.67 per hour

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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