Remote Insurance Claims Jobs in Bend, OR (NOW HIRING)

Clinical Inpatient Pharmacy Technician - Audit & Review

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 team of Clinical Inpatient Pharmacy Technicians are living our mission to make health care easier and lives better. As a member of the Post Service Claim Review team, our Clinical Inpatient Pharmacy Technicians conducts post-service audits to ensure billing accuracy, analyzes billings for consistency with medical records and reimbursement policies, and performs projects as requested by supervisors - all in service of making our members' health journeys easier.

Do you have a passion for pharmaceutical knowledge and ensuring billing accuracy through detailed post-service audits? Do you thrive in analyzing complex medical records and coordinating workflow activities as part of a quality-focused team? Then, this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• Certification as a Pharmacy Technician

• 2 years of experience in hospital or residential treatment facility

• 3 years of health insurance claims experience or analytical experience

• Equivalent combination of education and experience may be considered

• Payment review or coding experience is a plus

Skills and Attributes:

• Demonstrated competency in claim review and experience with billing and claims forms

• In-depth knowledge of drugs and pharmaceuticals, including IV fluids and off-label medication uses

• Strong problem-solving skills and demonstrated initiative

• Ability to consistently meet productivity and quality standards with minimal support

• Capability to work in fast-paced, multi-tasking environment with changing priorities

• Effective oral and written communication skills with healthcare documentation familiarity

• General computer skills including Microsoft Office, Outlook, and Internet search

What You Will Do at Cambia:

• Prioritize work and coordinate activities to ensure timely record reviews and audits

• Analyze billings to verify charges align with medical records and reimbursement policies

• Evaluate and interpret drug administration and treatment information when needed

• Ensure all work meets corporate standards and complies with federal, state, and accreditation regulations

• Maintain organized reference documents and follow established policies and procedures

• Meet production requirements and quality standards for all assigned work

• Support department efficiency through flexibility and cross-training on various functions

#LI-Remote

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$30.30 - $40.90 an hour, the full salary range is $28.40 - $46.30 an hour and the bonus target is10%.

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.

As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.