Pricing Reimbursement Analyst I or II

Cambia Health Solutions•Salt Lake, UT

5d•Hybrid

About The Position

Cambia is hiring a Pricing and Reimbursement Analyst I or II for its Provider Reimbursement team. The role analyzes, develops, and maintains contract payment terms and reimbursement rates for institutional, facility, and professional healthcare providers across all regions and Regence subsidiaries. It implements and sustains accurate contract payments negotiated by Regence. This is a hybrid position requiring three days per week in the office. The listed office locations are Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston, Little Rock, and Springdale. Preference is given to current employees and candidates who live within commuting distance of the Salt Lake City, Boise, Fargo, Lewiston, Little Rock, or Springdale offices, or are willing to relocate. The Analyst collaborates across internal teams and with external parties to ensure provider payments are implemented accurately and promptly. The role loads and maintains rates, researches reimbursement methodologies and pricing issues, creates and updates payment exhibits, and supports reimbursement strategies. Analyst II candidates must also demonstrate direct Pricing and Reimbursement Analyst experience and leadership in corporate projects. Pay varies by work location and level. For Oregon, Utah, and Idaho, the expected hiring ranges are $58,700–$79,400 for Analyst I and $70,600–$95,500 for Analyst II; each role has a 6% bonus target. For North Dakota, the expected hiring ranges are $52,800–$71,400 for Analyst I and $63,500–$85,900 for Analyst II; each role has a 6% bonus target. The posting also lists full salary ranges by location and level. Cambia describes itself as a purpose-driven organization focused on person-centered and economically sustainable healthcare. The company offers competitive compensation, benefits, career development, community outreach opportunities, and employee resource groups. Most roles have work-from-home options subject to wired internet requirements. New hires need access to a personal mobile device for multifactor authentication. A background check is required.

Requirements

Bachelor’s degree in business or a related field and at least two years of healthcare industry experience, including one year of project-related experience, or an equivalent combination of education and work experience.
At least three years of claims processing experience and knowledge of various reimbursement methods.
Ability to read, interpret, and apply provider contracts, medical and hospital pricing methodologies, and billing practices with strong attention to detail and accuracy.
Knowledge of Regence plan systems and pricing logic sufficient to serve as a knowledgeable pricing resource.
Analytical ability to identify problems, develop creative solutions, and implement effective courses of action in a timely manner.
Ability to work independently with minimal supervision and recognize when manager involvement is required.
Strong verbal and written communication skills to coordinate activities across varying staff levels, external agencies, and medical professionals.
Ability to contribute to and lead corporate projects, demonstrating maturity, tact, and diplomacy.
Proficiency in Microsoft Office Suite, including Excel, Word, and Access, and SQL query development; ability to analyze data, identify discrepancies, and validate updates accurately and completely.
Ability to review and audit peers’ work for accuracy and completeness.
Ability to author and improve team documentation that translates complex processes into clear, user-friendly materials.
Analyst II requires at least two years of direct Pricing and Reimbursement Analyst experience with demonstrated expertise.
Analyst II requires demonstrated leadership in corporate projects, significant decision-making, and active participation while working as a Pricing and Reimbursement Analyst I.
Access to a personal mobile device to set up multifactor authentication upon joining the company.
For work-from-home options, a wired internet connection that is not satellite or cellular, with a minimum upload speed of 5 Mbps and minimum download speed of 10 Mbps.

Responsibilities

Collaborate with Provider Services, Network Management, corporate business support, operations staff, and others to ensure negotiated provider and institutional payments are implemented correctly and promptly.
Load and maintain rates in appropriate system files to accurately price professional and facility claims, ensuring programming changes are implemented correctly and on time.
Research, analyze, and implement provider reimbursement methodologies and support development of new reimbursement strategies.
Create payment exhibits attached to provider contracts and maintain updates to CPT, DRG, AP-DRG, HCPCS, per diem, ICD-9, and HCPCS coding changes.
Research contract and pricing issues that may result in overpayments or underpayments, recommend corrective actions, and coordinate solutions.
Liaise with internal departments and divisions to ensure understanding of contract and billing issues involving providers, hospitals, and other contracted facilities.
Maintain computer hardware and software, recommend equipment or software purchases to support pricing schedules and methodologies, and provide documentation for end-user processing guidelines.
Participate in the local Regence Reimbursement Subcommittee and represent the Regence plan at state or regional meetings and committees.
For Analyst II, provide demonstrated leadership and significant decision-making participation in corporate projects.
Review and audit peers’ work for accuracy and completeness before finalization.
Author and enhance team documentation that explains processes in clear, user-friendly materials.

Benefits

Competitive salary
Bonus opportunities
401(k) plan with company match and potential discretionary company-performance contribution
Medical insurance
Dental insurance
Vision insurance
Mental health benefits
Annual employer contribution to a health savings account
Paid time off
10 company-paid holidays
Up to 12 weeks of paid parental time off, subject to eligibility requirements
Wellness programs with participation rewards
Employee Assistance Fund
Commute and parking benefits
Career growth and development opportunities
Employee resource groups
Cambia-supported community outreach opportunities