Remote Payment Integrity Nurse I — Claim Review & Coding

Cambia Health Solutions; Vancouver (WA); Remote; USD 77,000 - 104,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Health savings account contributions

Paid time off and holidays

Retirement plan with company match

Parental leave up to 12 weeks

Wellness programs

Job summary

Cambia Health Solutions is seeking a Payment Integrity Nurse I to conduct post service review of claims and ensure accurate coding and appropriate reimbursement. The role supports the Post Service Claim Review team, with pay ranges that vary by state and location.

The position emphasizes clinical expertise, policy compliance, and collaboration with physicians and other departments. Remote work options are available across multiple states.

Qualifications

• Associates or Bachelor's Degree in Healthcare or equivalent.
• Unrestricted licensure in OR, WA, ID, or UT; RN license preferred.
• CPC certification preferred from AAPC/AHIMA.

Responsibilities

• Apply nursing expertise to ensure compliance with medical and reimbursement policies.
• Ensure documentation follows federal regulations and policies.
• Review claims with medical records to ensure proper payment.

Skills

Nursing experience

Clinical review

Coding knowledge

AI tools experience

Communication skills

Education

Associates or Bachelor's Degree in Healthcare

RN license

CPC certification (preferred)

Tools

Microsoft Word

Excel

PowerPoint

Job description

Cambia Health Solutions is seeking a Payment Integrity Nurse I to conduct post service review of claims and ensure accurate coding and appropriate reimbursement. The role supports the Post Service Claim Review team, with pay ranges that vary by state and location.

The position emphasizes clinical expertise, policy compliance, and collaboration with physicians and other departments. Remote work options are available across multiple states.