Coordination of Benefits Specialist I - COB

Coordination of Benefits Specialist I

Work from home within Washington, Oregon, Idaho, Utah

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 COB Benefits Specialist are living our mission to make health care easier and lives better. As a member of the Claims Operations team, our benefits specialists handle requests for coordination of benefits with other insurance carriers including Medicare, investigating and verifying other carrier information from members and providers through multiple sources, including claims and Customer Service tasks.

Specialists create manual letters to members in a Client Letter application. Determining primary coverage based on state and federal guidelines, as well as internal documentation. When determining order of coverage, considers and applies all documented legal decisions that may pertain to the member’s situation. While updating the COB file and related notes in Facets, ensuring that member claims will coordinate correctly. – all in service of making our members health journeys easier.

Do you enjoy solving complex problems? Do you want to make a meaningful impact in healthcare? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• High school diploma

• 1 year office experience, preferably in health insurance claims

• Experience in medical office setting or equivalent combination of education and experience.

Skills and Attributes:

• Computer experience and familiarity with software such as MS Word and Excel.

• Ability to communicate effectively verbally and in writing.

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

• Works collaboratively with Customer Service, Membership, and claims analysts.

• Demonstrated analytical ability in identifying problems and in performing in-depth investigation.

What You Will Do at Cambia:

• Manages comprehensive coordination of benefits across all lines of business, including fully insured, self-insured, individual, and HCA members, while processing both Non-MSP and MSP files through departmental email systems.

• Handles complex Medicare coordination scenarios, including ESRD/CH42 Medicare issues, while negotiating coverage disputes with other carriers.

• Investigates and resolves escalated cases including Insurance Division complaints, providing detailed root cause analysis for leadership while handling highly visible work streams.

• Collaborates with various internal departments to resolve system and processing issues, suggesting and creating documentation updates in KMT to improve operational efficiency.

• Serves as a mentor and trainer for new hires, providing constructive feedback during training sessions and audits while maintaining quality standards.

• Functions as backup lead during supervisor absence, demonstrating leadership capabilities and ensuring continuous workflow management.

• Applies expertise to resolve complex coordination disputes and system issues, working cross-functionally to ensure accurate benefits coordination and member satisfaction.

#LI-remote

The starting hourly range for the COB Benefits Specialist is $18.00 - $23.50 /hour, depending on candidate's geographic location, certification and experience. The full pay range is $17.75 - $26.80 an hour.

The annual incentive payment target for this position 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.