Claims Production Professional I

Claims Production Professional

• Remote Within WA, OR, ID, UT Candidates outside these states will not be considered.
• Claims Production Professional Starting Pay range is $17.40-19.25, depending on experience and location. Human Resources will reach out and provide specific information.
• Training will last approximately 12 weeks. 100% attendance during training is required.
  
  

Primary Job Purpose

Provide basic data entry, claims processing and coordination of benefits by investigating and applying contract benefits to submitted claims while meeting department standards for quantity, accuracy, timeliness, and dependability. Provides responsive customer service to members, providers and other business partners.

Responsibilities

• Adapt to daily changes in workload/responsibilities based upon department/division goals and priorities
• Adapt to regular system, procedural and contract changes as they affect your daily processing
• Analyze and investigate claims for processing in a timely and accurate manner
• Apply benefits to claims by following all necessary warning messages and edits to ensure accurate claim completion
• Consistently adhere to all department established performance expectations for quality and production
• Follow all established department rules for behavior, attendance, appearance, and timekeeping
• Identify and report any irregularities or problems in claims processing to the appropriate area
• Maintain access to and utilize all references, documents, policies, and procedures to ensure correct application of contract benefits
• Maintain confidentiality in all aspects of claims processing, including correspondence and contacts
• Provide clear audit trails on claims processed so others can easily complete work in case of absence
• Provide excellent customer service to customers, providers, members, and member representatives
• Review and reprocess previously adjudicated claims
• Successfully complete basic claims training and any departmental audit process
• Other duties as assigned
  
  

Minimum Requirements

• Computer experience needed including working knowledge of Microsoft Office software, such as MS Word, Outlook, and Excel, or other comparable programs
• Basic math skills
• Keyboarding skills
• Strong attention to detail
• Excellent interpersonal skills
• Communicate effectively orally and in writing
• Work independently as well as a member of a team
• Ability to work under pressure and meet deadlines
• Meet dependability, timeliness, attendance, quantity, and quality standards as established by department
• Provide excellent customer service when communicating with external and internal customers
  
  

Normally To Be Proficient In The Competencies Listed Above

Claims Production Professional I would have a high school diploma or equivalent and 1 year office experience, preferably in health insurance claims or in a medical office setting, or equivalent combination of education and experience.

Work Environment

• Duties are performed in a high-volume, fast-paced office environment
• Repetitive keying movements
• Sitting for extended periods of time processing and investigating claims
• Travel to other locations, as job requires
• Work primarily performed in office environment.
• May be required to work overtime.
• May be required to work outside normal hours.
  
  

The base hourly range for Claims Production Professional is $17.40-19.25/hour.

The bonus target for this position is 5%.

At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we do not hire candidates at or near the top of the pay range.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, You Can

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
  
  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

Benefits

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.
  
  

Learn More About Our Benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Salary : $17