Program Integrity Analyst Jobs (NOW HIRING)

Performance Integrity Analyst I

Work fromhome within Oregon, Washington,Idaho, Utah

Build a career with purpose. JoinourCauseto create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia's dedicated Performance Integrity Analysts I, are living our mission to make health care easier and lives better. As a member of the Quality Training and Documentation team, our Performance Integrity Analysts audit high dollar claims according to established provider contracts, pricing methodologies, core systems, procedures, and audit guidelines. They submit findings to accountable business owners for review and acceptance, validate that required corrective actions have been completed, and provide 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

What You Will Do at Cambia:

• Audit claims for accuracy according to audit policies, procedures, and guidelines

• Encourage team and individual contributions toward the company's quality initiatives and improvement efforts

• Participate in team efforts to develop or update department standards

• 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

• Identify and report inconsistencies or ambiguities in manuals, policies, and guidelines

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.

• Oregon, Washington, Utah, and Idaho:The expected hiring range is$19.20 - $26.80/hourand the full salary range is$19.20 - $34.90/hour.

• The bonus target for this position is5%.

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.