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Remote Medical Claims Processor Jobs in Portland, OR

Deloitte

Epic Denials Management Operator

Portland, OR · Remote

$19 - $25.50/hr

... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Moda Health

Medical CS Rep I (***)

Portland, OR · Remote

$18.39 - $20.23/hr

These can include explaining benefits, claims processing and other details of the plan. This is a ... A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work.

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All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Portland, OR

Remote Medical Claims Processor information

See Portland, OR salary details

$14

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$27

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

As of Aug 21, 2026, the average hourly pay for remote medical claims processor in Portland, OR is $20.65, according to ZipRecruiter salary data. Most workers in this role earn between $18.37 and $22.93 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.

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

Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in Portland, OR as of August 2026, with employment types broken down into 57% Full Time, 29% Part Time, and 14% Contract. Highlights an 100% Remote job distribution, with an average salary of $42,943 per year, or $20.6 per hour.

Claims Representative - Workers Compensation | Jurisdiction: WA | Licensing: WA - Hybrid

Sedgwick

Portland, OR • Remote

Full-time

Medical, Dental, Vision, Retirement

Re-posted 4 hours ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 326 frontline employees who took The Breakroom Quiz

213th of 311 rated insurance

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Claims Representative - Workers Compensation | Jurisdiction: WA | Licensing: WA - Hybrid

Are you lookingfor an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

  • Apply yourClaims Representative, WC knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

  • Enjoy flexibility and autonomy in your daily work, your location, and your career path.

  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE?We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

WORK LOCATIONS: Hybrid work schedule, 2 days in office 3 days working from home.

PRIMARY PURPOSE OF THE ROLEToanalyze low level workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

  • Negotiating settlement of claims within designated authority.

  • Communicating claim activity and processing with the claimant and the client.

  • Reporting claims to the excess carrier and responding to requestsofdirections in a professional and timely manner.

QUALIFICATIONS

Education & Licensing:High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.Professional certification as applicable to line of business preferred.

Experience:2years of claims management experience or equivalent combination of education and experience required.

Licensing / Jurisdiction Knowledge: WA

TAKING CARE OF YOU

  • Flexible work schedule.

  • Referral incentive program.

  • Opportunity to work in an agile environment.

  • Career development and promotional growth opportunities.

  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTSINCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding,travel as required

Auditory/Visual: Hearing, vision and talking

#claimsexaminer#claims #hybrid#LI-REMOTE#Sedgwick #Hotjobs #portland #oregon

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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