Performance Integrity Analyst I, II, III

Cambia Health Solutions

Performance integrity analyst auditing health plan claims, enrollment, and customer service for Cambia. Monitoring accuracy, trends, and service-level performance across four states.

Posted 8/21/2026full-timeRemote • Idaho, Oregon, Utah, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $19 - $42 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in auditing claims, membership, and customer service processes while ensuring compliance with established policies and performance goals. Proficient in generating reports and analyzing performance statistics to drive quality improvement initiatives.

Highest-signal resume keywords

Claims AuditingPerformance AnalysisQuality ImprovementMathematical Concepts ApplicationAI Tools Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims CodingMembership ProcessesCustomer Service ProcessesPerformance Statistics CompilationReport GenerationPolicy ComplianceData AnalysisProblem InvestigationService-Level Goals MonitoringDepartment Standards Development

Soft Skills

Team CollaborationFeedback ProvisionCommunication SkillsAttention to DetailProblem-Solving

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookAI ToolsPricing SystemsProvider Contract Language

Industry Keywords

ClaimsMembershipCustomer ServiceAudit GuidelinesQuality InitiativesPerformance GoalsDepartment Policies

About the role

Key responsibilities & impact

Examine and validate Plan and employee performance according to established policies, procedures and mandated audit guidelines
Monitor accuracy and timeliness of claims, membership and customer service against performance and service-level goals
Provide reports, feedback and recommendations for quality improvement to management
Audit claims, enrollment or customer service activities for accuracy and timeliness
Encourage team and individual contributions toward company quality initiatives
Participate in developing or updating department standards
Provide feedback on department performance against service and performance-level goals
Stay current on applicable departmental policies, procedures and guidelines
Thoroughly investigate problems
Identify and report inconsistencies or ambiguities in manuals, policies and guidelines
Compile performance statistics and identify potential trends
Generate reports
Participate in testing implemented system changes

Requirements

What you’ll need

Four years of experience in Claims, Membership or Customer Service, depending on current business need, or equivalent combination of education and job-related experience
Audit experience desirable
Ability to understand and apply mathematical concepts
Proficient PC skills and familiarity with Word, Excel and Outlook
Knowledge of claims coding, BlueCard, membership and customer service processes
Knowledge of applicable systems, including pricing and provider contract language
Experience with AI tools and technologies highly desired
Wired internet connection that is not satellite or cellular, with minimum upload speed of 5Mb and download speed of 10Mb for work-from-home employees
Access to a personal mobile device for MFA
Successful background check
Must work from home within Oregon, Washington, Idaho or Utah

Benefits

Comp & perks

Competitive salary
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
Bonus opportunities
Work-from-home options
Employee resource groups
Cambia-supported community outreach programs
Wired internet connection requirement for work-from-home employees
Personal mobile device for Multi-Factor Authentication