Customer Service Ambassador - Partners In Care (PIC)

Customer Service Ambassador - Partners In Care (PIC)

Work from home within Portland, Vancouver, Renton, Salt Lake City, Boise, Medford, Burlington, and Lewiston. Preference will be given to current employees and candidates who reside in Salt Lake City, Boise, and Lewiston.

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.  

Who We Are Looking For: 

Every day, Cambia’s dedicated team of Partners in Care Customer Service Ambassadors is living our mission to make health care easier and lives better. As a member of the Partners in Care (PIC) team, our PIC Customer Service Ambassadors serve as the department's subject matter expert; support and coach Customer Service staff; handle escalated and complex member and provider inquiries, grievances, and appeals; and ensure resolution in alignment with corporate policy and regulatory requirements – all in service of making our members’ health journeys easier. 

Are you someone who takes ownership of escalated challenges and sees them through to resolution? Do you bring patience, knowledge, and care to every interaction — no matter how complex? Then this role may be the perfect fit. 

What You Bring to Cambia: 

Qualifications:  

• High school diploma or GED required

• Minimum of 3 years of progressive member service experience

• Equivalent combination of education and relevant technical work experience may be considered

Skills and Attributes: 

• Ability to report, analyze, and identify data trends to develop a course of action and evaluate outcomes

• Quickly and accurately assess member inquiries and requirements by establishing a rapport with inquirer in order to understand his/her service needs; identify errors promptly and determine corrective steps for resolution

• Adhere to dependability, member and provider focus, and all performance criteria as established by the department

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia:  

• Handle and resolve escalated and complex calls, claims, and inquiries from members, providers, employer groups, and other healthcare professionals

• Research and resolve claims, benefit administration errors, appeals, and correspondence issues in accordance with company policy and regulations

• Explain benefits, eligibility, claims procedures, pre-authorizations, and grievance/appeal processes to members, providers, and staff

• Coach, mentor, and support Customer Service staff through one-on-one guidance, help line support, and participation in training and onboarding

• Collaborate with internal departments including Medical, Legal, Provider Relations, Claims, and Pharmacy Services to resolve complex issues

• Analyze data and trends to identify recurring issues and provide ongoing education and recommendations to Customer Service leadership

• Serve as the department's subject matter expert on company policies, products, processes, and Coordination of Benefits 

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.

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $28.40 - $36.35 an hour, the full salary range is $24.40 - $42.20 an hour, and the bonus target is 5%.

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 (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). 
• 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.

As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.