[Remote] Performance Integrity Analyst I

Note: The job is a remote job and is open to candidates in USA. Cambia Health Solutions is dedicated to creating a person-focused and economically sustainable health care system. They are seeking a Performance Integrity Analyst I to audit high dollar claims according to established guidelines, provide feedback for quality improvement, and support the company's quality initiatives.

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

Skills

• 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
• Audit experience desirable

Benefits

• The bonus target for this position is 5%.
• 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.
• Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.
• 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.
• 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.

Company Overview