Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. This role supports members, providers and various internal departments by mentoring staff, monitoring workflow, maintaining performance measures and ensuring timely and quality claims processing while adhering to State, Federal and company guidelines.
Bachelor’s degree (Preferred)
3 years of experience related to claims processing, preferred in the healthcare industry
Demonstrated leadership/supervisory experience, or the equivalent combination of education and experience.
• You'll lead a team of claims professionals, setting priorities, overseeing work outputs and timelines, and developing productivity, quality, and service standards to ensure exceptional performance.
• You'll possess strong analytical skills, identifying problems, trends, and developing solutions to implement a course of action, while also communicating effectively with all levels of the organization, both verbally and in writing.
• You'll have a deep understanding of the insurance industry, related regulations, and mandates, as well as experience working in a high-volume claims processing center, with a proven track record of managing performance and creating an environment for service excellence.
• You'll be able to organize, plan, and prioritize assignments within multiple projects, participating in and managing well-defined projects with minimal guidance, and leveraging your knowledge of medical terminology and/or claims coding to inform your decision-making.
• As a leader, you'll be responsible for developing and training your team, including employees in multiple locations or working remotely, and fostering a culture of collaboration, innovation, and customer-centricity to drive results and achieve business objectives.
• You'll lead and manage a team of claims professionals, assigning and prioritizing work, setting goals, and coordinating daily activities, while also providing regular updates and communication through 1:1 and team meetings.
• You'll monitor individual and team results, ensuring work is completed in a timely manner, in accordance with department standards and procedures, and in compliance with medical policy and guidelines, and identify areas for process improvements.
• You'll act as a resource for staff and others, escalating issues and partnering with other departments to resolve them, and participate in the selection process, provide ongoing coaching and performance management, and write performance reviews.
• You'll facilitate the maintenance of reference manuals, work procedures, and procedural guidelines, and complete special projects as assigned, including leading division projects, implementing process improvement projects, and analyzing data to present to departmental leadership.
• You'll oversee claims processing, ensuring accuracy and timeliness according to company timelines, and provide support services, including scheduling, reporting to management, meeting facilitation, and issue resolution, while also participating on project teams to recommend solutions and translate business requirements.
#LI-remote
The expected hiring salary range is $61,000 - $82,800 a year depending on skills, experience, education, and training; relevant licensure / certifications; and performance history.
The bonus target for this position is 10%. The current full salary range for this role is $57,000 - $94,000.
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:
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:
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.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
National Interstate Insurance Company
SOCOTEC
Allstate Identity Protection
IEHP
ComPsych