Job Description

Insurance Dept Inquiry Specialist

Work Remotely from Oregon, Washington, Idaho or Utah

Primary Job Purpose

Responds to consumer and provider complaints sent to state insurance departments; advocates for Cambia\xe2\x80\x99s position or, if necessary, overturns decision; works closely with management to ensure systemic operational problems identified through the consumer complaint process are resolved or improved.

General Functions and Outcomes

Researches and responds to consumer inquiries and complaints forwarded by state insurance regulators.

Uses independent judgment to research and respond to consumer inquiries and complaints forwarded by state insurance regulators. Determines outcome, if any, based on facts and circumstances of complaint.

Maintains knowledge of insurance statues and rules in primary markets; interprets state insurance rules and regulations to determine responses to consumer complaints.

Represents the company and interacts with all company departments, as well as insurance departments; and takes all appropriate actions to build and maintain trust relationships with such persons.

Minimum Requirements

Significant and in-depth knowledge of all Cambia health benefit contracts, systems, and processes related to those contracts, including all Cambia claims and member systems.

Knowledge of insurance laws and regulations applicable to Cambia health benefit contracts and the administration of those contracts.

Ability to advocate for Cambia\xe2\x80\x99s position with state regulatory staff.

Knowledge of general office practices and procedures.

Knowledge of simple mathematics, grammar and techniques of business and legal composition.

Use of standard office equipment including telephone, personal computer, facsimile machine, calculator, copier and dictation/transcription equipment.

Proficiency in Windows PC applications, including Microsoft Word, Outlook, MITS and Remedy.

Must be able to work with minimal supervision and assume increasingly complex responsibilities.

Normally to be proficient in the competencies listed above

Insurance Department Inquiry Specialist would have a Bachelor\xe2\x80\x99s degree in liberal arts, business or health care field and three years of experience in customer service, communications or legal department or equivalent combination of education and job-related work experience.

Work Environment

• Travel may be required, locally or out of state
• May be required to work outside normal hours

The expected hiring range for a Insurance Dept Inquiry Speclst is $60,000.00 - $82,000.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 5%. The current full salary range for this role is $56,500.00 to $92,500.00.

#LI-remote

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

medical, dental, and vision coverage for employees and their eligible family members

annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)

paid time off varying by role and tenure in addition to 10 company holidays

up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)

up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)

one-time furniture and equipment allowance for employees working from home

up to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our page.

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 . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our . As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our site.

Cambia Health Solutions