About this role
Claims Examiner II is an intermediate-level role responsible for reviewing, investigating, and adjudicating Medicaid, Medicare, group and individual medical, dental, and mental health claims. The position operates within a health plan to ensure claims comply with plan provisions, state and federal regulations, and organizational policies. The role supports customer service and cross-department collaboration while maintaining quality and productivity standards.
Required Skills
- Medical Coding
- Claims Adjudication
- Data Entry
- Customer Service
- Microsoft Office
- Analytical Skills
- Time Management
- Communication
About CareOregon
careoregon.orgWhether you’re a current Oregon Health Plan (OHP) Medicaid member or want to become one, CareOregon is here to help you get the best health care.
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