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Moda Health

42 Moda Health Customer Service Representative Jobs Hiring Near You

Moda Health

Membership Acct Qual Analyst

Portland, OR · On-site

... Customer Service, Business Implementation Unit (BIU), Accounting, IS, and Medicare Operations. Externally with Clients and Customers. Together, we can be more. We can be better. Moda Health seeks to ...

Moda Health

Medical Claims Auditor I

Milwaukie, OR · On-site

It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda ... High school diploma or equivalent. * 6 months - 2 years claim processing or customer service ...

Moda Health

Medical Claims Processor I

Milwaukie, OR · On-site

Works internally with the customer service, membership accounting, and appeals departments. Works externally to support client needs. Together, we can be more. We can be better. Moda Health seeks to ...

Moda Health

Inpatient Claims Processor I

Milwaukie, OR · On-site

... Customer Service, Hospital Auditors, Provider Correspondence, and Professional Relations. Works externally with providers and vendors. Together, we can be more. We can be better. Moda Health seeks to ...

Moda Health

Quality Assurance Auditor

Milwaukie, OR · On-site

It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda ... Contracting, Customer Service, Membership Accounting, Claims, Legal Services, Regulatory ...

Moda Health

Manager, Clinical Pharmacy

Portland, OR · Remote

Interdepartmental work within the company including Actuary & Analytics, Customer Service, Healt ... Moda Health seeks to allow equal employment opportunities for all qualified persons without regard ...

Moda Health

Workforce Management Analyst I

Portland, OR · On-site

... customer service and occasionally with IT department. Externally with outsource vendor partner and occasionally with NICE support personnel. Together, we can be more. We can be better. Moda Health ...

Moda Health

Dental Claims Processor I

Milwaukie, OR · Remote

Internally with Imaging Services, Claim Support, and Professional Relations. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified ...

Moda Health

Sr Software Engineer

Portland, OR · On-site

Externally with software vendors, customers, and technical staff from groups and state agencies. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities ...

Moda Health

Software Engineer

Portland, OR · On-site

It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda ... Bachelor's degree in a relevant field (Computer Science, Software Engineering, Information Services ...

Moda Health

Sales Assistant I

Portland, OR · Remote

It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda ... Provides excellent customer service. * Prepares Welcome/Enrollment packets and group administrative ...

Moda Health

Supervisor, Medical Claims

Milwaukie, OR · Remote

It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda ... service goals, tracks processors production and quality. * Assists with planning by analyzing ...

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Moda Health Jobs Information

What is it like to work at Moda Health?

Moda Health is a values-driven organization that prioritizes collaboration, innovation, and a commitment to improving the health and well-being of its members and the communities it serves.

The company operates with a team-based structure, fostering an open and supportive work environment where employees can share ideas and work together to achieve common goals. Moda Health's mission is to provide high-quality, affordable healthcare solutions that meet the unique needs of its members.

Working at Moda Health may appeal to individuals who are passionate about healthcare and are looking for a dynamic and collaborative work environment where they can make a meaningful contribution to improving the lives of others.

Do workers at Moda Health get paid breaks?

Yes. Most people get paid breaks.
100% of people say they get paid breaks.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and April 2026.

Does Moda Health pay people when they’re sick?

Yes. Most people get paid when they’re sick.
78% of people say they would get paid if they were sick but scheduled to work.
Based on data from 18 people who took the Breakroom Quiz between December 2024 and April 2026.

At Moda Health, are sick days and vacation days separate paid time off?

Sick days and vacation days are used from the same paid time off.
90% of people say they have to use vacation days when they’re out sick.
Based on data from 10 people who took the Breakroom Quiz between June 2025 and April 2026.

Is the health insurance from Moda Health affordable enough for their workers?

Most people say the health insurance costs are okay.
85% of people say the health insurance costs are okay
Based on data from 13 people who took the Breakroom Quiz between March 2025 and April 2026.

Do people get paid time off at Moda Health?

Most people get paid time off work.
100% of people say they get paid time off.
Based on data from 10 people who took the Breakroom Quiz between June 2025 and April 2026.

Do workers at Moda Health worry about hours?

Most people don’t worry about getting enough hours.
90% of people report they don’t worry about getting enough hours.
Based on data from 10 people who took the Breakroom Quiz between December 2024 and April 2026.

How easy is it to get time off at Moda Health?

Most people find it easy to get time off.
80% of people report it’s easy to get time off.
Based on data from 15 people who took the Breakroom Quiz between December 2024 and March 2026.

Do Moda Health managers change schedules at the last minute?

Most managers don’t change people’s schedules at the last minute.
92% of people say their manager doesn’t change their shift schedule at the last minute.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and April 2026.

Do jobs at Moda Health spill into time workers aren’t paid for?

Rarely. The job doesn't usually spill into unpaid time.
23% of people report that their job takes up time that they don’t get paid for.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and April 2026.

How easy is it to take sick days at Moda Health?

Most people find it easy to take sick days.
89% of people report that it’s easy to take time off if they are sick.
Based on data from 19 people who took the Breakroom Quiz between December 2024 and March 2026.

Is working at Moda Health good if you’re a parent or caregiver?

Most parents and caregivers say this is a good place to work.
100% of people who care for a child or other relative report this is a good place to work.
Based on data from 10 people who took the Breakroom Quiz between January 2025 and March 2026.

Do people at Moda Health feel treated with respect by their managers?

Most people feel treated with respect by their managers.
95% of people say they’re treated with respect by their managers.
Based on data from 20 people who took the Breakroom Quiz between December 2024 and April 2026.

Do people at Moda Health get to take their breaks without interruption?

Most people get breaks without interruption.
89% of people report that they get to take their breaks without interruption.
Based on data from 18 people who took the Breakroom Quiz between December 2024 and April 2026.

Is it stressful to work at Moda Health?

Some people feel stressed out here.
47% of people say they often feel stressed out at work.
Based on data from 17 people who took the Breakroom Quiz between December 2024 and March 2026.

Do people at Moda Health enjoy their jobs?

Most people enjoy their job.
83% of people report they enjoy their job.
Based on data from 18 people who took the Breakroom Quiz between December 2024 and March 2026.

Do people at Moda Health recommend working with their team?

Only some people recommend working with their team.
35% of people report that they wouldn’t recommend working with their immediate team to a friend.
Based on data from 20 people who took the Breakroom Quiz between December 2024 and April 2026.

Do people get enough training when they start at Moda Health?

Most people got enough training when they started.
78% of people report they got enough training when they started working here.
Based on data from 18 people who took the Breakroom Quiz between December 2024 and March 2026.

Do people get support to advance at Moda Health?

Most people are given support to advance their career here.
In the last year, 90% of people report being given support to advance their career here.
Based on data from 20 people who took the Breakroom Quiz between December 2024 and April 2026.

Do people think Moda Health’s headquarters understands what’s happening where they work?

Some people think headquarters doesn’t understand what’s happening where they work.
65% of people think that this employer’s headquarters or owners don’t have a good understanding of what’s really happening where they work.
Based on data from 20 people who took the Breakroom Quiz between December 2024 and April 2026.

Do workers feel well informed about how Moda Health is doing?

Only some people feel well informed about how the company is doing.
39% of people feel that they aren’t kept well informed about how the company is doing as a whole.
Based on data from 18 people who took the Breakroom Quiz between December 2024 and March 2026.
What other companies are hiring for Customer Service Representative jobs?
What are the most popular jobs at Moda Health?
Infographic showing various Customer Service Representative job openings at Moda Health in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 72% Physical, and 28% Remote job distribution.
Membership Acct Qual Analyst

Membership Acct Qual Analyst

Moda Health

Portland, OR • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Moda Health rating

8.7

Company rating: 8.7 out of 10

Based on 20 frontline employees who took The Breakroom Quiz

62nd of 260 rated insurance

Job description

Let’s do great things, together

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
Provide accurate quality assurance auditing of pre and post enrollment, billing and reconciliation functions as performed by Membership Accounting specialists of all levels. Track and report on quality trending as it relates to specific specialists as well as department level production. This is a full-time WFH role.


Pay Range
$23.34 - $26.26hourly, DOE.
*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=27778496&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. High School diploma or equivalent required.
  2. 1-2 years quality review experience in a health insurance environment, preferably in a Membership Accounting (enrollment, billing & reconciliation) department preferred.
  3. Demonstrate strong, effective, and diplomatic interpersonal skills with employees of all levels and participate effectively as a team player.
  4. Knowledge of Word, Excel, and ability to navigate web-based programs.
  5. Excellent reading, verbal, and written communication skills, and the ability to interact professionally, patiently, and courteously with others.
  6. Good analytical, problem solving, decision making and organizational, and detail-oriented skills with ability to shift priorities.
  7. Ability to come in to work on time and on a daily basis. Maintain attendance above company standards.
  8. Maintain confidentiality and project a professional business presence and appearance.


Primary Functions:

  1. Audit enrollments, billings and reconciliation daily using statistically valid sampling methodology, using prescribed audit criteria. Performs simple adjustments as necessary.
  2. Ensures departmental quality assurance standards, employer group Statement of Work, and State and Federal Regulations are adhered to through auditing all Membership Accounting Specialist duties.
  3. Conduct in-depth enrollment, billing, and reconciliation on performance groups, as well as focused audits for specifically identified situations or specialists on a scheduled basis.
  4. Prepares required monthly and/or quarterly reports for specific group performance guarantees, production, and accuracy results.
  5. Identify trends from audit results and recommend improvements to increase overall quality.
  6. Creates and updates documentation, department procedures, and resource materials as needed.
  7. Responsible for quality and continuous improvement within job scope.
  8. Contributes to and supports the company’s quality initiatives by encouraging team and individual contributions toward the company’s quality improvement efforts.
  9. Fosters and atmosphere of team spirit and portrays an outgoing and positive attitude with peers, Moda and BHS Leadership, Customers, trainees, and Specialists.
  10. Responsible for regularly scheduled operational audits of staff members for your respective team and product line.
  11. Other duties as assigned.
Working Conditions & Contact with Others:

  • 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.

  • Internally with Membership Accounting Leadership Team, Sales and Account Services, Customer Service, Business Implementation Unit (BIU), Accounting, IS, and Medicare Operations. Externally with Clients and Customers.

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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