Claims Review Associate

Talentoma; Oregon; Remote; USD 88,000 - 96,000; Full time

Benefits offered by this job

Fully remote from Oregon

Structured onboarding

Claims training

Job summary

Talentoma is seeking a methodical Claims Review Associate for a fully remote role based in Oregon. You will connect claim-file details, coverage language, and payment records to reach well-supported outcomes.

Prior experience in claims operations, quality review, finance support, or document auditing is a plus. Responsibilities include reviewing files for completeness, verifying payments and deductibles, identifying inconsistencies, and preparing clear findings and recurring-error reports for

Qualifications

• Experience with claims review or financial reconciliation.
• Knowledge of claim lifecycles and coverage terms.
• Ability to interpret policy language against evidence.
• Proficient with claims platforms and audit tools.
• Remote work from Oregon with onboarding and training.

Responsibilities

• Review claim files, loss reports, policy provisions, and documents for completeness.
• Verify payments, reserves, deductibles, and entries against documentation.
• Identify inconsistencies or processing exceptions and route to adjusters.
• Perform quality sampling and document results in audit trackers.
• Prepare findings summaries and recurring-error reports for stakeholders.
• Handle policyholder and claim information per privacy and compliance standards.

Skills

Claims review

Financial reconciliation

Quality assurance

Transaction auditing

Policy language interpretation

Claims platforms

Spreadsheets

Audit-tracking tools

Decision making

Tools

Audit-tracking software

Spreadsheets

Job description

Monthly Pay: $7,900 - $8,600 USD per month

Summary:

This full-time remote role suits a methodical reviewer who enjoys connecting claim-file details, coverage language, and payment records to reach well-supported outcomes. Candidates with experience in claims operations, quality review, finance support, or document auditing will thrive in this associate-level position.

Job Responsibilities:

• Review claim files, loss reports, policy provisions, and supporting documents for completeness.
• Verify payment calculations, reserves, deductibles, and transaction entries against file documentation.
• Identify inconsistencies, missing evidence, or processing exceptions and route findings to adjusters.
• Perform quality sampling and document review results in audit trackers and claim systems.
• Prepare clear findings summaries and recurring-error reports for operational stakeholders.
• Handle policyholder and claim information according to privacy, compliance, and file-handling standards.

Qualifications:

• Experience with claims review, financial reconciliation, quality assurance, or transaction auditing.
• Working knowledge of claim lifecycles, coverage terms, deductibles, and payment documentation.
• Ability to interpret policy language and compare it with claim-file evidence.
• Comfort using claims platforms, spreadsheets, and audit-tracking tools.
• Sound judgment when documenting exceptions and prioritizing review queues.
• Fully remote work from Oregon.
• Structured onboarding and claim-review training.
• Access to quality-calibration sessions and peer learning.
• Professional development opportunities in claims operations and financial controls.