Underwriting Specialist I
About The Position
The Underwriting Specialist I supports Cambia’s Risk Adjustment process by contacting identified members and providers through phone, email, or letter to encourage health care visits and help ensure accurately coded claims are received. The role also supports Care Management referrals, application processing and eligibility review, customer service for people inquiring about potential or pending policies, and the administration and retention of underwriting documents and records. The position may process applications using the Plan rating tool, validate and release approved application files to Membership for activation, prepare correspondence, maintain production statistics, and apply current Underwriting, State, and Federal policy requirements. The role must comply with MTM and HIPAA privacy standards. It is remote for candidates working from Oregon, Washington, Idaho, or Utah, with work primarily performed in an office environment and no unusual working conditions.
Requirements
- High school diploma or GED and one year of medical office, customer service, or call center experience, or an equivalent combination of education and experience.
- Ability to exercise sound judgment, initiative, and discretion in a mature, sensitive, and confidential manner.
- Ability to type 30 words per minute with 95% accuracy.
- Computer skills, including experience with Microsoft Office (Word, Excel, and Outlook) or comparable software, and ability to learn and use complex systems.
- Ability to organize, prioritize, and manage multiple tasks.
- Ability to establish effective working relationships with coworkers and customers.
- Dependability and ability to maintain attendance and production standards at or above department standards.
- Ability to communicate effectively orally and in writing.
Nice To Haves
- Knowledge of medical terminology.
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings.
Responsibilities
- Contact identified members and providers by phone, email, or letter to encourage health care visits.
- Prepare and validate processed files for imaging and retention; coordinate document retention and storage; maintain records of received documents; and produce application files from electronic sources.
- Enter document numbers for approved files into the tracking system, validate and enter application approval or acceptance information, and release files to Membership for activation.
- Produce and audit outgoing correspondence, and research and document miscellaneous correspondence received by the department.
- Make, receive, and document phone calls.
- Apply changes to Underwriting, State, or Federal policies to ensure current requirements are met.
- Track production statistics.
- Comply with MTM and HIPAA Privacy standards.
Benefits
- Medical, dental, and vision coverage for employees and eligible family members, including mental health benefits.
- Annual employer contribution to a health savings account.
- Paid time off varying by role and tenure, in addition to 10 company-paid holidays.
- 401(k) retirement plan with company match and potential discretionary contribution based on company performance.
- Up to 12 weeks of paid parental time off, subject to eligibility requirements.
- Wellness programs.
- Employee Assistance Fund.
- Commute and parking benefits.
- Bonus opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
