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Remote Medical Claims Processor Jobs in Forest Grove, OR

Risen Medical

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DME Order Processing Representative - Remote

Portland, OR · Remote

$22/hr

Minimum of six (6) months of health industry experience in a medical office or processing medical claims, and, minimum of six (6) months customer service experience, communicating with customers or ...

Corvel

Claims Specialist

Portland, OR · Remote

$52K - $85K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Corvel

Claims Supervisor

Portland, OR · On-site +1

$73K - $113K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Supervises WC claims staff in ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Corvel

Claims Supervisor

Portland, OR · Remote

$73K - $113K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Supervises WC claims staff in ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

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How much do remote medical claims processor jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote medical claims processor in Forest Grove, OR is $20.61, according to ZipRecruiter salary data. Most workers in this role earn between $18.32 and $22.88 per hour, depending on experience, location, and employer.

What is a remote medical claims processor?

Remote medical claims processors handle billing paperwork for health care offices or insurance companies. Instead of working in the office, remote medical claims processors complete their job duties from home or another location outside of the office with internet connectivity. As a remote medical claims processor, your responsibilities include ensuring medical insurance claims have proper billing codes that match the services provided, clarifying patient concerns about benefits, and adding changes made to the claim by the doctors or insurer. You may also be required to follow up with the insurer to find out the status of claims and discuss any discrepancies.

What does a remote medical claims processor do?

A Remote Medical Claims Processor reviews, evaluates, and processes insurance claims submitted by healthcare providers and patients. Working from a remote location, they verify the accuracy of claim information, ensure proper coding, and determine whether services are covered based on insurance policies. They also communicate with providers, patients, and insurance companies to resolve discrepancies or request additional information. This role helps ensure that claims are processed efficiently and accurately for timely reimbursement.

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

To thrive as a Remote Medical Claims Processor, a solid understanding of medical terminology, insurance policies, and claims adjudication is essential, typically supported by a high school diploma or equivalent and relevant experience. Familiarity with claims management software, electronic health records (EHR) systems, and knowledge of HIPAA regulations are typically required. Attention to detail, strong organizational skills, and clear written communication help individuals excel in processing claims accurately and efficiently. These skills ensure timely and correct claims processing, reducing errors and supporting the financial health of both healthcare providers and patients.

How does a remote medical claims processor typically collaborate with healthcare providers and insurance companies while working from home?

As a Remote Medical Claims Processor, collaboration with healthcare providers and insurance companies primarily occurs through secure digital communication channels, such as email, specialized claims management software, and phone calls. You will regularly interact with provider offices to clarify patient information, verify coverage, or resolve discrepancies in submitted claims. While the role is independent, you often coordinate with team members and supervisors virtually to ensure claims are processed efficiently and accurately. Maintaining clear documentation and communication is essential for resolving issues and minimizing processing delays.

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

AspectRemote Medical Claims ProcessorRemote Medical Billing Specialist
CredentialsTypically requires medical coding or claims processing certificationsOften requires medical billing certifications and coding knowledge
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare providers or billing companies
Industry UsageInsurance companies, third-party administratorsHospitals, clinics, billing service providers
Job FocusProcessing and reviewing insurance claims for reimbursementPreparing and submitting bills, managing accounts receivable

While both roles work remotely within the healthcare industry, the Remote Medical Claims Processor primarily reviews and processes insurance claims, focusing on reimbursement. In contrast, the Remote Medical Billing Specialist handles billing procedures, including preparing and submitting invoices. Both roles require similar certifications and often overlap in work environment and employer types, but their core responsibilities differ in claim review versus billing management.

More about Remote Medical Claims Processor jobs

What cities near Forest Grove, OR are hiring for Remote Medical Claims Processor jobs?

Cities near Forest Grove, OR with the most Remote Medical Claims Processor job openings:

Remote Medical Claims Processor jobs near you

Supervisor, Healthcare Services Claims - Internal Applicants Only

Moda Health

Portland, OR • Remote

$59K - $74K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 23 days ago

Moda Health rating

8.5

Company rating: 8.5 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

107th of 309 rated insurance

Job description

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:

This is a Hybrid Position. Provides supervision, coaching and support to Claims Processors.  Organizes staff, sets goals, establishes procedures, and continues to ensure claims are processed promptly and accurately.  Measures and evaluates performance and results.  Coaches and trains as required to achieve goals of quality and efficiency.

 

Pay Range
$59,922.05 - $74,902.56 ​​​annually (depending on experience)
*This role may be classified as hourly (non-exempt) depending on the applicant's location. 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=27779680&refresh=true

Benefits:

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


Required Skills, Experience & Education:

  1. College degree or equivalent work experience.
  2. 2 – 4 years medical claims processing experience, including 1 year as Senior/Lead processor.
  3. Computer proficiency in company’s systems and Word and Excel.
  4. Strong verbal, written and interpersonal communication skills.
  5. Strong analytical, problem solving and decision-making skills.
  6. Ability to work well under pressure with frequent interruptions and shifting priorities.
  7. Ability to come in to work on time and daily.
  8. Maintain confidentiality and project a professional business image.

Primary Functions:

  1. Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, conducting performance reviews, and hiring and training new employees.
  2. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
  3. Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality.
  4. Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs.
  5. Motivates and coaches the processors by reviewing results with them, conveys to them what is expected of them, asks for suggestions, and fulfills the needs of training.
  6. Use and manipulate excel files.
  7. Other duties as assigned.

Working Conditions:

Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need.

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 & Danielle Baker via our humanresources@modahealth.com email.

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