Healthcare Claims Appeals Specialist (Remote) in Portland, Oregon - #72287 | VanderHouwen

Description

Job Id: 72287

Healthcare Claims Appeals Specialist (Remote)
Our client is seeking a detail-oriented and analytical Healthcare Claims Appeals Specialist who thrives in a fast-paced, high-volume environment. This individual brings strong communication skills, sound judgment, and the ability to navigate complex claims scenarios while maintaining a customer-focused approach. The ideal candidate is adaptable, collaborative, and confident in working across teams to drive timely, accurate appeal resolutions.

This role is fully remote. Applicants must be located in Oregon, Washington, Utah, or Idaho.

Healthcare Claims Appeals Specialist (Remote) Responsibilities

• Manage the full lifecycle of provider billing disputes and appeals, including intake validation, analysis, determination, and closure.
• Review claims, coding, medical policies, contracts, and regulatory requirements to develop well-supported appeal recommendations.
• Coordinate with clinical reviewers and cross-functional partners to ensure accurate and timely resolution of complex cases.
• Communicate appeal outcomes and provide guidance to members, providers, and external parties while maintaining professionalism and confidentiality.
• Track, document, and report on appeal activity, ensuring compliance with timelines, quality standards, and internal policies.

Healthcare Claims Appeals Specialist (Remote) Qualifications

• Minimum 4 years of experience in healthcare claims, appeals, customer service, or clinical services, or equivalent combination of education and experience.
• Strong knowledge of medical terminology and coding (e.g., CPT, ICD/DX, HCPCS), with coding certification preferred.
• Demonstrated analytical and problem-solving skills with the ability to interpret complex policies and regulations.
• Excellent written and verbal communication skills, with the ability to explain detailed information clearly and diplomatically.
• Proficiency with Microsoft Office tools and experience navigating claims or healthcare-related systems in a remote environment.

Compensation: $30-$33/hr. (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.

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