Performance Integrity Analyst I-1

Cambia Health Solutions; Remote; USD 60,000 - 80,000; Full time

Job summary

A health care company is seeking a Performance Integrity Analyst I for their remote team. This role involves auditing claims for accuracy and providing feedback to improve service levels. The ideal candidate will have at least two years of relevant experience and strong skills in claims coding, data analysis, and effective communication. This position offers competitive pay between $20.50 and $30.80 per hour, with numerous benefits including flexible work options and a robust retirement plan.

Benefits

Medical, dental, and vision coverage

Annual employer contribution to health savings account

Generous paid time off

Market-leading retirement plan

Paid parental time off

Award-winning wellness programs

Commute and parking benefits

Qualifications

• Two years of experience or equivalent education.
• Detail-oriented and able to communicate effectively.
• Proficient with corporate software such as Word, Excel, and Outlook.

Responsibilities

• Audit claims for accuracy according to policies and guidelines.
• Compile performance statistics and identify trends.
• Participate in team efforts to develop/update department standards.

Skills

Ability to understand and apply mathematical concepts

Demonstrated proficient PC skills

Knowledge of claims coding

Audit experience

Ability to organize and prioritize work

Detail-oriented and self-motivated

Effective communication skills

Experience with AI tools

Education

Two years experience as a Claim processor or equivalent

Tools

Word

Excel

Outlook

Facets

eVIPS

Radar

Job description

Performance Integrity Analyst I

Work from home Within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia's dedicated Performance Integrity Analyst I, are living our mission to make health care easier and lives better. As a member of the Data Analyst team, our Performance Integrity Analyst will examine and validate Plan and employee performance according to established policies, procedures and mandated audit guidelines. Monitor accuracy and timeliness of claims, membership and customer service to meet performance and service level goals. Provide reports, feedback and recommendations for quality improvement to management, all in service of creating a person-focused health care experience.

Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

Two years of experience as a Claim processor or an equivalent combination of education and job-related experience, depending on current business needs

Skills and Attributes:

• Ability to understand and apply mathematical concepts
• Demonstrated proficient PC skills and familiarity with corporate software, such as Word, Excel, and Outlook
• Knowledge of claims coding, and applicable systems including Facets, eVIPS, and Radar
• Audit experience desirable
• Ability to organize and prioritize work
• Must be detail-oriented and self-motivated
• Must be able to communicate effectively both orally and in writing
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia:

• Audit claims for accuracy according to audit policies, procedures, and guidelines while encouraging team and individual contributions toward the company's quality initiatives and improvement efforts.
• Participate in team efforts to develop or update department standards and provide feedback on department's performance in reaching service and performance level goals.
• Remain continuously current on changes and/or additions to all other applicable departments' policies, procedures, and guidelines.
• Thoroughly investigate problems and identify and report inconsistencies or ambiguities in manuals, policies, and guidelines.
• Compile performance statistics and identify potential trends.
• Generate reports.
• Participate in testing implemented system changes.

#LI – Remote

The expected hiring range for a Performance Integrity Analyst I is $20.50 - $30.80 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $19.20 - $34.90 an hour.

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.

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 (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• 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 employer dedicated to 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 [e-mail]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.