Performance Integrity Analyst I

Cambia Health Solutions • Medford, OR

12d • $19 - $27 • Remote

About The Position

Performance Integrity Analyst I Work from home within Oregon, Washington, Idaho, 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 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.

Requirements

• Two years of experience as a claim processor, or an equivalent combination of education and job-related experience, depending on current business needs.
• 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
• Ability to organize and prioritize work
• Must be detail-oriented and self-motivated
• Must be able to communicate effectively both orally and in writing

Nice To Haves

• Audit experience desirable

Responsibilities

• 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed