Remote Healthcare Underwriter Specialist I

Cambia Health Solutions, Inc.; Burlington (WA); Remote; USD 27,000 - 37,000; Full time

Benefits offered by this job

Remote work options

Competitive benefits package

401(k) with company match

Paid time off and holidays

Parental leave

Job summary

Cambia Health Solutions, Inc. is seeking an Underwriter Specialist I for a remote role, allowing work from Oregon, Washington, Idaho, or Utah.

The role focuses on outreach to members to encourage care visits and ensure accurately coded claims for Risk Adjustment, plus eligibility and records processing. Ideal candidates have a high school diploma or GED and 1 year of medical office or customer service experience.

Qualifications

• High School diploma or GED and 1 year medical office, customer service or call center experience or equivalent combination of education and experience.
• Knowledge of medical terminology preferred.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings is highly desired

Responsibilities

• Perform outreach to identified members and providers via phone, email or letter to encourage health care visits.
• Prepare and validate processed files for imaging and retention; coordinate document retention and storage, manage and maintain records of received documents and produce application files from electronic sources.
• Enter document numbers for approved files into tracking system, validate and enter application approval/acceptance information and release file to Membership for activation.
• Produce correspondence, audit all outgoing correspondence and research and document miscellaneous correspondence received by department.
• Make, receive and document phone calls.
• Incorporate and apply changes made to Underwriting, State or Federal policies to ensure current requirements are met.
• Track production statistics.
• Comply with MTM and HIPAA Privacy standards.

Skills

Type 30 wpm

Microsoft Office

Organization

Communication

Confidential handling

AI tools experience

Education

High School diploma or GED

Tools

Microsoft Word

Excel

Outlook

Job description

Cambia Health Solutions, Inc. is seeking an Underwriter Specialist I for a remote role, allowing work from Oregon, Washington, Idaho, or Utah.

The role focuses on outreach to members to encourage care visits and ensure accurately coded claims for Risk Adjustment, plus eligibility and records processing. Ideal candidates have a high school diploma or GED and 1 year of medical office or customer service experience.