Blue Card Multi Service Specialist Claims

Blue Card Multi Service Specialist

Full-time work from home candidates in WA, ID, OR, UT only.

Starting pay range $18.00 - $21.00 an hour depending on experience and location. HR will reach out and provide specific information.

Who We Are Looking For 

Every day, Cambia’s dedicated team of Blue Card Specialists are living our mission to make health care easier and lives better.

BlueCard Multi Service Specialist I processes a variety of BlueCard claim types, adjustments and medical records. BlueCard Multi Service Specialists also serves as a liaison between the Provider Contact Center, Provider Networking team, and other business areas to resolve outstanding claim-related issues with other BCBS plans.

Do you have a passion for serving others and learning new things? Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit. 

Qualifications:

• High school diploma or equivalent

• 1 year of experience in Claims or Membership

• Call Center/Contact Center Customer Service or equivalent combination of education and experience

Skills and Attributes:

• PC experience and familiarity with corporate software (e.g., MS Word, Excel, or comparable software) are required, as well as strong claims processing skills and ability to apply medical terminology and ICD-10/CPT coding.

• Effective communication and listening skills are essential to promote positive, professional interactions while maintaining confidentiality and sensitivity in all internal and external contacts, as well as providing excellent customer service to customers, providers, members, and internal staff.

• The ability to work independently, make decisions, and exercise sound judgment is crucial, along with critical thinking skills to analyze situations and make informed decisions.

• Organizational and time management skills are necessary to prioritize workload, meet deadlines, and adapt to changing priorities and workload demands based on the Claims Division's goals.

• Reliability, flexibility, and a strong work ethic are expected to meet job requirements, including quality, quantity, timeliness, knowledge, and dependability standards described by department goals.

What You Will Do at Cambia

• Process new claims, corrected claims, misrouted claims, and respond to incoming Adjustments Requests from other BCBS plans, ensuring accurate and efficient claims processing.

• Apply knowledge of medical terminology, ICD-10, CPT coding, and other resources to resolve claim issues, and request and process needed Medical Records from Providers as necessary.

• Recognize and adapt to all policies and procedures that apply to claims, including daily changes in workload/responsibilities based on Claims Division goals/priorities, and maintain confidentiality in all aspects of claims processing.

• Maintain accurate and up-to-date documentation, including clear and concise audit trails, and keep all relevant documents, policies, procedures, and guidelines readily accessible to ensure compliance with MTM and Consortium standards.

• Meet the demands of the role by working overtime and on weekends as needed, and being flexible to changes that affect the job, including contract changes, procedure or system changes, and other assigned projects or duties as assigned by management.

Your Work Environment

• Duties performed primarily in an office environment.

• Ability to physically perform essential job duties.

• May sit and key at PC for extended periods of time.

#LI-remote

The starting hourly wage for this job is $18.00 - $21.00/hour, depending on candidate's geographic location and experience. 

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care.  Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:  

• Work alongside diverse teams building cutting-edge solutions to transform health care.  
• 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.  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.  

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: 

• 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. 

Learn more about our 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.