[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f1vF8TcFoaqFz5YwsaoWBknBV9bbiCShbm9vGG91Yomo":3,"$fUj2mwWR_qUaHe2da62IFYonDw8Ywb0fD8DqFQfxS5ck":34},{"id":4,"slug":5,"title":6,"company":7,"company_logo_url":8,"category":9,"subcategory":10,"job_type":11,"experience_level":12,"remote_type":13,"country":14,"city":10,"language":15,"salary_min":16,"salary_max":17,"salary_currency":18,"salary_type":19,"skills":20,"benefits":10,"description_short":26,"source_url":27,"apply_url":27,"source_site":28,"is_active":29,"is_featured":30,"views_count":31,"click_count":31,"posted_at":32,"collected_at":33,"expires_at":10,"visa_sponsorship":30,"company_size":10},30045,"claims-examiner-ii-name-5eb5f3528d1b","Claims Examiner II","name","thumbnail_url","Healthcare",null,"full-time","mid","remote","United States","en",47465,58011,"USD","yearly",[21,22,23,24,25],"Claims-Examiner","Claims-Processing","Healthcare-Insurance","Medical-Claims-Adjudication","Health-Insurance","Claims Examiner IIThe Claims Examiner II is an intermediate level position responsible for the timely review, investigation and adjudication of all types of Medicaid, Medicare, group and individual medical, dental, and mental health claims.\u003Ch3>Estimated Hiring Range:\u003C\u002Fh3>$22.82 - $27.89\u003Ch3>Bonus Target:\u003C\u002Fh3>Bonus - SIP Target, 5% Annual\u003Cp>Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.\u003C\u002Fp>\u003Ch3>\u003Cb>Essential Responsibilities\u003C\u002Fb>\u003C\u002Fh3>\u003Cul>\u003Cli>Adjudicate medical, dental and mental health claims in accordance and compliance with plan provisions, state and federal regulations, and CareOregon policies and procedures. \u003C\u002Fli>\u003Cli>Re-adjudicate, adjust or correct claims, including some complex and difficult claims as needed.\u003C\u002Fli>\u003Cli>Consistently meet or exceed the quality and production standards established by the department and CareOregon.\u003C\u002Fli>\u003Cli>Provide excellent customer service to internal and external customers.\u003C\u002Fli>\u003Cli>Collaborate and share information with Claims teams and other CareOregon departments to achieve excellent customer service and support organizational goals.\u003C\u002Fli>\u003Cli>Determine eligibility, benefit levels and coordination of benefits with other carriers; recognize and escalate complex issues to the Lead or Supervisor as needed.\u003C\u002Fli>\u003Cli>Investigate third party issues as directed.\u003C\u002Fli>\u003Cli>May review, process and post refunds and claim adjustments or re-adjudications as needed.\u003C\u002Fli>\u003Cli>Report any overpayments, underpayments or other possible irregularities to the Lead or Supervisor as appropriate.\u003C\u002Fli>\u003Cli>Generate letters and other documents as needed.\u003C\u002Fli>\u003Cli>Proactively identify ways to improve quality and productivity.\u003C\u002Fli>\u003Cli>Continuously learn and stay up to date with changing processes, procedures and policies.\u003C\u002Fli>\u003C\u002Ful>\u003Ch3>Experience and\u002For Education\u003C\u002Fh3>\u003Ch3>Required\u003C\u002Fh3>\u003Cul>\u003Cli>Minimum 2 years’ experience as a Medical Claims Examiner or other role that requires knowledge of medical coding and terminology (e.g., medical billing, prior authorizations, appeals and grievances, health insurance customer service, etc.)\u003C\u002Fli>\u003C\u002Ful>\u003Ch3>Preferred\u003C\u002Fh3>\u003Cul>\u003Cli>Minimum 2 years’ experience as a Medical Claims Examiner\u003C\u002Fli>\u003Cli>Experience using QNXT, Facets, Epic systems\u003C\u002Fli>\u003Cli>Knowledge of CPT, HCPCS, Revenue, CDT and ICD-10 coding\u003C\u002Fli>\u003C\u002Ful>\u003Ch3>Knowledge, Skills and Abilities Required\u003C\u002Fh3>\u003Ch3>Knowledge\u003C\u002Fh3>\u003Cul>\u003Cli>Knowledge of CPT, HCPCS, Revenue, CDT and ICD-10 coding\u003C\u002Fli>\u003Cli>Knowledge of medical, dental, mental health and health insurance terminology\u003C\u002Fli>\u003C\u002Ful>\u003Ch3>Skills and Abilities\u003C\u002Fh3>\u003Cul>\u003Cli>Understanding of or ability to learn state and federal laws and other regulatory agency requirements that relate to medical, dental, mental health and health insurance industry and Medicaid\u002FMedicare industry\u003C\u002Fli>\u003Cli>Ability to perform fast and accurate data entry\u003C\u002Fli>\u003Cli>Strong spoken and written communication skills\u003C\u002Fli>\u003Cli>Basic computer skills (ability to use Microsoft Outlook, Word and Excel) and learn new systems as needed\u003C\u002Fli>\u003Cli>Good customer service skills\u003C\u002Fli>\u003Cli>Ability to participate fully and constructively in meetings\u003C\u002Fli>\u003Cli>Strong analytical and sound problem-solving skills\u003C\u002Fli>\u003Cli>Detail orientation\u003C\u002Fli>\u003Cli>Strong organizational skills and time management skills\u003C\u002Fli>\u003Cli>Ability to work in a fast-paced environment with multiple priorities\u003C\u002Fli>\u003Cli>Ability to work effectively with diverse individuals and groups\u003C\u002Fli>\u003Cli>Ability to learn, focus, understand, and evaluate information and determine appropriate actions\u003C\u002Fli>\u003Cli>Ability to accept direction and feedback, as well as tolerate and manage stress\u003C\u002Fli>\u003Cli>Ability to see, read, hear, speak, and perform repetitive finger and wrist movement for at least 6 hours\u002Fday\u003C\u002Fli>\u003Cli>Ability to lift, carry, reach, and\u002For pinch small objects for at least 1-3 hours\u002Fday\u003C\u002Fli>\u003C\u002Ful>\u003Ch3>Working Conditions\u003C\u002Fh3>\u003Cp>Work Environment(s): ☒ Indoor\u002FOffice ☐ Community ☐ Facilities\u002FSecurity ☐ Outdoor Exposure\u003C\u002Fp>\u003Cp>Member\u002FPatient Facing: ☒ No ☐ Telephonic ☐ In Person\u003C\u002Fp>\u003Cp>Hazards: May include, but not limited to, physical and ergonomic hazards.\u003C\u002Fp>\u003Ch3>Equipment: General office equipment\u003C\u002Fh3>\u003Cp>Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.\u003C\u002Fp>\u003Ch3>Work Location: Work from home\u003C\u002Fh3>\u003Cp>Schedule: Monday - Friday, 8:00 AM to 5:00 PM\u003C\u002Fp>\u003Cp>\u003Cb>We offer a strong Total Rewards Program.\u003C\u002Fb> This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked\u002Fscheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.\u003C\u002Fp>\u003Ch3>We are an equal opportunity employer\u003C\u002Fh3>\u003Cp>CareOregon is an equal opportunity employer.  The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.\u003C\u002Fp>\u003Cp>Originally posted on \u003Ca href=\"https:\u002F\u002Fhimalayas.app\">Himalayas\u003C\u002Fa>\u003C\u002Fp>","https:\u002F\u002Fhimalayas.app\u002Fcompanies\u002Fcareoregon-inc\u002Fjobs\u002Fclaims-examiner-ii","himalayas",true,false,0,"2026-05-18T11:04:22.553247+00:00","2026-05-18T11:05:37.590834+00:00",{"jobs":35,"total":75,"facets":76},[36,52,60,69],{"id":37,"slug":38,"title":39,"company":40,"company_logo_url":10,"category":9,"subcategory":41,"job_type":11,"experience_level":10,"remote_type":42,"country":43,"city":44,"language":15,"salary_min":45,"salary_max":45,"salary_currency":46,"salary_type":19,"skills":10,"benefits":10,"description_short":47,"source_url":48,"apply_url":48,"source_site":49,"is_active":29,"is_featured":30,"views_count":31,"click_count":31,"posted_at":50,"collected_at":51,"expires_at":10,"visa_sponsorship":30,"company_size":10},54924,"registrar-pho-paediatrics-joblinx-2f2bc6164f19","Registrar\u002FPHO\u002FPaediatrics","JobLinx","Healthcare & Nursing Jobs","onsite","Australia","Bathurst-Orange Region, New South Wales",270400,"AUD","A Northern NSW hospital requires Registrar\u002FPHO in Paediatrics for the following date(s). Shift(s) details as below: from 22\u002F06\u002F2026 13:00 to 24\u002F06\u002F2026 23:00 at $130 per hour For further information about this job, please contact Skilled Medical on 1300 900 100. The rate is $130.00\u002Fhour A regional referral Level 5 base hospital providing a range of healthcare services including: acute and emergency care, surgical services, women’s care and newborn services, intensive and coronary care units, Me…","https:\u002F\u002Fwww.adzuna.com.au\u002Fland\u002Fad\u002F5738398512?se=7ASHR5dW8RGTDdJK-7cL6w&utm_medium=api&utm_source=ac2be355&v=B54E2FA6529D23E48BF3990B8C310D69726CD727","adzuna","2026-05-23T14:41:52+00:00","2026-05-23T11:06:50.593528+00:00",{"id":53,"slug":54,"title":55,"company":40,"company_logo_url":10,"category":9,"subcategory":41,"job_type":11,"experience_level":10,"remote_type":42,"country":43,"city":56,"language":15,"salary_min":10,"salary_max":10,"salary_currency":46,"salary_type":19,"skills":10,"benefits":10,"description_short":57,"source_url":58,"apply_url":58,"source_site":49,"is_active":29,"is_featured":30,"views_count":31,"click_count":31,"posted_at":59,"collected_at":51,"expires_at":10,"visa_sponsorship":30,"company_size":10},55006,"registrar-general-surgery-joblinx-8c6c9a417d8b","Registrar | General Surgery","Essendon North, Moonee Valley","An Western VIC hospital requires a Registrar\u002FPHO in Surgery from 16\u002F05\u002F2026 to 31\u002F07\u002F2026. For further information about this job, please contact Victoria O'Mahony on 1300 900 100. Night $176per hour Day $166 per hour Mixture of shifts - Days & Nights Preference for doctor to complete the full block Share style accommodation provided. About Skilled Medical Skilled Medical is a leading international medical recruitment firm that delivers qualified medical professionals wherever they are needed i…","https:\u002F\u002Fwww.adzuna.com.au\u002Fland\u002Fad\u002F5738398404?se=9pwLSZdW8RGmXsuRD8pltQ&utm_medium=api&utm_source=ac2be355&v=A9F1A0627D0E6EF2B54BEF256FB8CBBD55131DFB","2026-05-23T14:41:51+00:00",{"id":61,"slug":62,"title":63,"company":40,"company_logo_url":10,"category":9,"subcategory":41,"job_type":11,"experience_level":10,"remote_type":42,"country":43,"city":64,"language":15,"salary_min":65,"salary_max":65,"salary_currency":46,"salary_type":19,"skills":10,"benefits":10,"description_short":66,"source_url":67,"apply_url":67,"source_site":49,"is_active":29,"is_featured":30,"views_count":31,"click_count":31,"posted_at":68,"collected_at":51,"expires_at":10,"visa_sponsorship":30,"company_size":10},54996,"registrar-pho-emergency-medicine-joblinx-40c729ee2375","Registrar\u002FPHO\u002FEmergency Medicine","Sydney CBD, Sydney",374400,"A Eastern NSW hospital requires Registrar\u002FPHO in Emergency Medicine for the following date(s). Shift(s) details as below: from 23\u002F05\u002F2026 14:00 to 24\u002F05\u002F2026 00:00 at $180 per hour from 12\u002F07\u002F2026 14:00 to 14\u002F07\u002F2026 00:00 at $180 per hour from 17\u002F07\u002F2026 14:00 to 19\u002F07\u002F2026 00:00 at $180 per hour For further information about this job, please contact Skilled Medical on 1300 900 100. The rate is $180.00\u002Fhour This hospital is a busy acute care facility which provides emergency services, elective…","https:\u002F\u002Fwww.adzuna.com.au\u002Fland\u002Fad\u002F5738398336?se=9pwLSZdW8RGmXsuRD8pltQ&utm_medium=api&utm_source=ac2be355&v=B7540C12AE5BDD090C7AD8BFF4B4BA29ECEB11AA","2026-05-23T14:41:50+00:00",{"id":70,"slug":71,"title":63,"company":40,"company_logo_url":10,"category":9,"subcategory":41,"job_type":11,"experience_level":10,"remote_type":42,"country":43,"city":64,"language":15,"salary_min":65,"salary_max":65,"salary_currency":46,"salary_type":19,"skills":10,"benefits":10,"description_short":72,"source_url":73,"apply_url":73,"source_site":49,"is_active":29,"is_featured":30,"views_count":31,"click_count":31,"posted_at":74,"collected_at":51,"expires_at":10,"visa_sponsorship":30,"company_size":10},54979,"registrar-pho-emergency-medicine-joblinx-77d962bc626f","A Eastern NSW hospital requires Registrar\u002FPHO in Emergency Medicine for the following date(s). Shift(s) details as below: from 13\u002F05\u002F2026 08:00 to 15\u002F05\u002F2026 18:30 at $180 per hour from 19\u002F05\u002F2026 08:00 to 22\u002F05\u002F2026 18:30 at $180 per hour For further information about this job, please contact Skilled Medical on 1300 900 100. The rate is $180.00\u002Fhour Providing health services for around 400,000 people. It is one of the region’s largest employers with a workforce of more than 8,500 staff operati…","https:\u002F\u002Fwww.adzuna.com.au\u002Fland\u002Fad\u002F5738398319?se=9pwLSZdW8RGmXsuRD8pltQ&utm_medium=api&utm_source=ac2be355&v=49E669C1DBA72A38B6C68BBC4A72C783EEF3B5F3","2026-05-23T14:41:49+00:00",3704,{"category":77,"mode":99,"experience":103,"type":108},{"Engineering":78,"Sales":79,"Design":80,"DevOps":81,"Product":82,"Operations":83,"Customer Support":84,"HR":85,"Education":86,"Marketing":87,"Writing":88,"Finance":89,"Healthcare":75,"Other":90,"Data":91,"Legal":92,"Hospitality":93,"Construction":94,"Retail":95,"Logistics":96,"Government":97,"Manufacturing":98},5535,1404,466,131,284,1628,437,650,1430,910,26,1505,9154,157,536,1786,1273,815,2068,398,382,{"remote":100,"onsite":101,"hybrid":102},88,3596,20,{"mid":104,"lead":105,"senior":106,"entry":107},31,151,52,32,{"full-time":109,"part-time":110,"contract":111},3238,462,4]