Cambia Health Solutions — Oregon shtatining Portlend shahrida joylashgan, tibbiy yordamni iste’molchiga yanada yo‘naltirishga e’tibor qaratadigan notijorat sog‘liqni saqlash tashkiloti. Regence sog‘liqni saqlash rejalari oilasining bosh tashkiloti sifatida u tibbiy sug‘urta va tibbiy yordam bilan bog‘liq bizneslarni yuritadi, shuningdek, odamlarning tibbiy xizmatlardan foydalanishi va ularni boshdan kechirish usullarini yaxshilashga mo‘ljallangan raqamli vositalar hamda xizmatlarni o‘z ichiga olgan sog‘liqni saqlash innovatsiyalariga sarmoya kiritadi.
Customer Service Ambassador – Partners in Care (Remote, United States)
Resolve complex member, provider, and claims-related issues as a Customer Service Ambassador with Cambia Health Solutions. Coach service teams and use trend analysis to strengthen member support.
Tavsif
- Act as the Partners in Care department’s subject matter expert
- Coach and support Customer Service representatives
- Resolve complex and escalated calls, claims, and inquiries from members, providers, employer groups, and healthcare professionals
- Investigate claims, benefit administration errors, appeals, and correspondence issues in line with company policies and regulations
- Explain benefits, eligibility, claims procedures, pre-authorizations, and grievance and appeal processes
- Provide mentoring through individual guidance, help-line assistance, training, and onboarding
- Partner with Medical, Legal, Provider Relations, Claims, and Pharmacy Services teams
- Review data and trends to uncover recurring issues
- Deliver ongoing education and recommendations to Customer Service leadership
- Confirm that resolutions comply with corporate policies and regulatory requirements
- Advise on company policies, products, processes, and Coordination of Benefits
Talablar
- High school diploma or GED
- At least three years of progressively responsible member service experience
- Equivalent education and relevant technical work experience may be considered
- Ability to report on and analyze trends, develop action plans, and assess outcomes
- Ability to evaluate member needs accurately, build rapport, identify errors, and determine corrective actions
- Reliable, member- and provider-focused approach with consistent adherence to departmental performance standards
- Experience with AI tools and technologies is strongly preferred
- A home-office setup with wired internet is required; satellite and cellular connections are not accepted, with minimum speeds of 5 Mbps upload and 10 Mbps download
- Personal mobile device for multi-factor authentication setup
- Successful completion of a background check
Imtiyozlar
- 5% target bonus
- Medical, dental, and vision insurance for employees and eligible family members, including mental health coverage
- Annual employer contribution to a health savings account
- Paid time off that varies by role and tenure
- 10 company-paid holidays
- Retirement plan with company matching on employee 401(k) contributions
- Potential discretionary retirement contribution tied to company performance, with no vesting period
- Up to 12 weeks of paid parental leave, subject to eligibility
- Wellness programs that recognize participation
- Employee Assistance Fund
- Commuter and parking benefits
- Flexible work-from-home options
- Employee resource groups
- Opportunities to participate in Cambia-supported community outreach
- Required wired internet connection and minimum speeds for remote work
- Personal mobile device access for multi-factor authentication