DO NOT APPLY - UWS I
Cambia Health

Primary Job Purpose

The Underwriting 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.

General Functions and Outcomes

• 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.

Minimum Requirements

• 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.

Normally to be proficient in the competencies listed above

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.

Work Environment

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

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 (eligible day one of employment if within first 12 months following birth or adoption).
• 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.

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.

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