Underwriting Specialist

Work remotely from Oregon, Washington, Idaho, or Utah. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Every day, Cambia’s dedicated team of Underwriters is living our mission to make health care easier and lives better.

As a member of the Underwriting team, our Underwriter Specialist I provides outreach to identified members using appropriate channels to encourage health care visits so accurately coded claims are received by Cambia supporting the Risk Adjustment process. Ensure appropriate referrals are made to Care Management programs. May process applications using the Plan rating tool in an accurate, timely fashion ensuring eligibility criteria is met.

Provide customer service to those inquiring about potential or pending policies – all in service of creating a person-focused health care experience.

Qualifications:

UW Specialist I would have a High School diploma or GED and 1 year medical office, customer service or call center experience or equivalent combination of education and experience.

• Demonstrated ability to exercise sound judgment, initiative and discretion in a mature, sensitive and confidential manner.
• Ability to type 30 wpm with 95% accuracy.
• Computer skills including experience using Microsoft Office (Word, Excel, Outlook) or comparable software and ability to learn and use complex systems.
• Ability to organize, prioritize and manage multiple tasks.
• Demonstrated ability to establish effective working relationships with coworkers and customers.
• Proven ability to be dependable and maintain attendance and production standards at or above department standards.
• Ability to communicate effectively both orally and in writing.
• Knowledge of medical terminology preferred.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

• Perform outreach to identified members and providers via phone, email or letter to encourage health care visits.
• Prepare and validate processed files for imaging and retention; coordinate document retention and storage, manage and maintain records of received documents and produce application files from electronic sources.
• Enter document numbers for approved files into tracking system, validate and enter application approval/acceptance information and release file to Membership for activation.
• Produce correspondence, audit all outgoing correspondence and research and document miscellaneous correspondence received by department.
• Make, receive and document phone calls.
• Incorporate and apply changes made to Underwriting, State or Federal policies to ensure current requirements are met.
• Track production statistics.
• Comply with MTM and HIPAA Privacy standards.

• No unusual working conditions.
• Work primarily performed in office environment.

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.

National pay structure — applies to the Boise and Lewiston, ;
Salt Lake City, UT, Oregon and Washington. The expected salary range is $19.64 - $26.57. The full salary range is $18.40 - $30.10 and the bonus target is 5%.

Regional pay structure — applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above:
The expected salary range is $17.68 - $23.92. The full salary range is $18.00 - $27.10 and the bonus target is 5%.

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation…