Cambia Health Solutions FEP Claims Refund Adjustment Analyst I, II or III DOE in Tacoma, Washington


Claims Refund Adjustment Analyst I, II or III DOE

Tacoma, WA

Responsibilities & Requirements

Bring your claims processing experience to our Claims Refund Adjustment Analyst Role. In the Claims Refund Adjustment Analyst role, you will respond to a variety of requests for refunds and adjustments. Verify information and pursue payments from members and providers through negotiating payment plans. Capture and record accurate recovery savings in a timely manner.

Claims Refund Adjustment Analyst I - Pay Level 9

Key Qualifications and Experience

  • Knowledge of medical terminology and ICD-9/CPT coding.

  • Previous claims processing experience.

  • Typing 30 wpm keyboarding skills or 8,500 keystrokes per hour with 95% accuracy.

  • 10 key ability and proficiency with calculator.

  • PC experience and knowledge of Word and Excel or similar Windows software.

  • Ability to perform basic math calculations.

  • Demonstrated excellent customer service skills.

  • Ability to communicate effectively orally and in writing.

  • Ability to organize work and set priorities to meet deadlines.

  • Decision making ability.

  • Ability to listen and communicate appropriately while providing service to the community, members, member representatives in a positive and professional manner.

Additional Minimum Requirements for level II - Pay Level 10

  • Ability to work independently with minimal direction and supervision.

  • Ability to meet deadlines and work under pressure.

  • Demonstrates the knowledge and ability to process multiple claim, refund and adjustment types and/or functions as established by the department.

  • Demonstrates a depth of knowledge to accurately handle complex claims.

  • Demonstrates advanced working knowledge of department software and systems.

Additional Minimum Requirements for level III - Pay Level 11

  • Ability to process multiple claims types and product lines.

  • Demonstrated working knowledge of all reports, as applicable to the department.

  • Proven decision making and leadership skills

About Us

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity 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 drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

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Requisition ID2018-24313

Category (Portal Searching)Claims/Appeals