Performance Integrity Analyst I-1
About The Position
Performance Integrity Analyst I 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 Performance Integrity Analyst I, are living our mission to make health care easier and lives better. As a member of the Data Analyst team, our Performance Integrity Analyst will examine and validate Plan and employee performance according to established policies, procedures and mandated audit guidelines. Monitor accuracy and timeliness of claims, membership and customer service to meet performance and service level goals. Provide reports, 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
- 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
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Nice To Haves
- Audit experience desirable
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Responsibilities
- Audit claims for accuracy according to audit policies, procedures, and guidelines while encouraging team and individual contributions toward the company's quality initiatives and improvement efforts.
- Participate in team efforts to develop or update department standards and 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 and identify and report inconsistencies or ambiguities in manuals, policies, and guidelines.
- Compile performance statistics and identify potential trends.
- Generate reports.
- Participate in testing implemented system changes.
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.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
