Medical Records Analyst I

Job not on LinkedIn

🔥 3 minutes ago

🥔 Idaho, Oregon, +2 more states – Remote

🥔 Idaho – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $21 - $38 / hour

⏰ Full Time

🟢 Junior

🧐 Analyst

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Cambia Health Solutions

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Cambia Health Solutions is a nonprofit, mission-driven healthcare company based in Portland, Oregon, that operates consumer-focused health care and health insurance businesses and invests in health innovation. It serves as the parent organization for the Regence family of health plans and runs initiatives and subsidiaries focused on improving care delivery, providing insurance products, and developing digital health tools and services.

📋 Description

• Triage selected claims against clinical review and audit criteria • Request and obtain provider medical records via letters or EMR • Receive, research, and process incoming records via fax, mail, email, and secure upload • Input claim processing instructions into Facets • Update required fields and notes in the department database • Interpret claim history and pre-authorization determinations as needed • Communicate with claims staff and Network Management regarding claim status and needed or missing records • Send detailed notification letters to providers • Meet production requirements and quality standards while following federal, state, BCBSA, and accreditation regulations • Remain flexible and cross-trained on other functions to support department efficiency

🎯 Requirements

• High school diploma or GED • 3 years of experience in a healthcare field (medical office, customer service, or billing); or related formal education and at least 1 year of experience; or an equivalent combination of education and experience • Experience with healthcare systems and documentation, including medical records, billing, and claims • Familiarity with the Facets system preferred • Proficiency with medical terminology • Knowledge of medical anatomy and coding preferred • Knowledge of Blue Card, ITS processes, FEP Direct, and Salesforce preferred • Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired • Math aptitude and analytical ability • Effective communication and writing skills • Ability to investigate and research issues related to clinical programs and medical records, and take initiative to solve problems • Ability to work independently, prioritize work, meet deadlines, and achieve operational standards • Ability to work from home within Washington, Idaho, Oregon, or Utah • Wired internet connection, not satellite or cellular, with minimum upload speed of 5Mb and download speed of 10 Mb • Access to a personal mobile device for Multi-Factor Authentication • Background check required

🏖️ Benefits

• 5% bonus target • Competitive salary • Market-leading 401(k) with a significant company match • Bonus opportunities • Medical, dental and vision coverage for employees and eligible family members, including mental health benefits • Annual employer contribution to a health savings account • Generous paid time off • 10 company-paid holidays • Market-leading retirement plan with company match on employee 401(k) contributions • Potential discretionary retirement contribution based on company performance, with no vesting period • Up to 12 weeks of paid parental time off after 12 months of continuous service • Award-winning wellness programs that reward participation • Employee Assistance Fund • Commute and parking benefits • Work from home options • Employee resource groups • Cambia-supported community outreach programs