Medical Claims Review Analyst in Portland, Oregon - #71869 | VanderHouwen

Description

Job Id: 71869

Medical Claims Review Analyst
Our client is seeking a detail-oriented Medical Claims Review Analyst who thrives in a fast-paced healthcare operations environment and enjoys working with complex claims and medical documentation. This role requires a strong analytical mindset, excellent communication skills, and the ability to manage multiple priorities while maintaining high standards of accuracy and compliance. The ideal candidate is proactive, organized, and comfortable collaborating with internal teams and external providers to support efficient claims review processes.

This role is fully remote. Applicants who reside in Oregon, Washington, Utah, or Idaho are preferred.

Medical Claims Review Analyst Responsibilities

• Review and triage selected medical claims to determine eligibility for clinical review based on defined audit and review criteria.
• Request, obtain, and organize medical records from providers through electronic medical record systems and other submission channels.
• Research and process incoming documentation received via fax, email, mail, or secure uploads to support claim review activities.
• Enter claim-related instructions, updates, and notes into internal systems while communicating status updates to claims and operational teams.
• Prepare and send provider communications, including record requests and notifications regarding missing or required documentation.

Medical Claims Review Analyst Qualifications

• High school diploma or GED with approximately 3+ years of experience in a healthcare setting such as medical office operations, claims processing, billing, or customer service, or an equivalent combination of education and experience.
• Experience working with healthcare documentation including medical records, billing information, or claims data.
• Strong written and verbal communication skills with the ability to prepare clear correspondence and provider requests.
• Working knowledge of medical terminology, anatomy, and healthcare processes; familiarity with claims systems such as Facets is a plus.
• Strong analytical, organizational, and problem-solving skills with the ability to prioritize tasks and meet production and quality standards.

Compensation: (DOE)

VanderHouwen Contractors Enjoy Exceptional Benefit Perks!
As an eligible contract employee with VanderHouwen, you’ll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.

Meet VanderHouwen
What kind of recruiter do you see yourself working with? One who prioritizes your best interest, no matter what? VanderHouwen does, and we’re in it for the long game! Our recruiters focus on YOU, building meaningful, long-term relationships while developing a deep understanding of companies’ staffing needs and workplace cultures. This approach helps us find an ideal job match that aligns with your unique career aspirations and goals.

VanderHouwen is an award-winning, Women & Diversity-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen places experienced professionals across the nation! Our recruitment teams specialize in either Technology and IT, Engineering, Human Resources, or Accounting and Finance career markets. Partner with us to land your next exciting career!

VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.

#LI-Remote