Remote Clinical Claims Review Specialist
Eugene, Lane County, Oregon, 97401, USA
Listed on 2026-10-20
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Healthcare
Healthcare Administration, Healthcare Compliance, Medical Records, Health Informatics
Moda Health seeks a detail-oriented Claims Reviewer to support the Medical Management team in reviewing, researching and triaging post-service claims. You will apply utilization review knowledge and work on retrospective reviews in a full-time work-from-home role.
Responsibilities include determining authorization needs, gathering medical records, and collaborating with providers and RN/supervisor on complex cases while ensuring HIPAA compliance and accurate data entry in Facets UM.
Join us at Moda Health as our next Remote Clinical Claims Review Specialist I in Portland, OR, United States.
Learn more about the Remote Clinical Claims Review Specialist I role in the description above.
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