$73,231 – $103,500
Listed on Cambia Health Solutions’s own careers site. You apply with them directly — we never stand between you and the employer.
What this role is
This role involves reviewing healthcare insurance claims using clinical expertise to ensure proper reimbursement and coding accuracy, serving on a team dedicated to protecting both patients and healthcare system integrity. It suits nurses with clinical backgrounds who want to apply their medical knowledge in a claims review and compliance capacity rather than direct patient care.
Our summary, not Cambia Health Solutions’s wording. The full posting is on their site.
Skills this role names
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What they ask for
Required
- Associates or Bachelors degree in Healthcare
- Minimum 3 years clinical, insurance, coding, claims review, or case management experience
- Unrestricted licensure or certification in OR, WA, ID, or UT in health or human services discipline
- Minimum 3 years direct clinical care experience
- Bachelors degree or higher in health/human services field OR current unrestricted RN license
- Knowledge of medical and surgical procedures
- Ability to read and interpret medical records
- Strong written and verbal communication skills
- Computer proficiency
- Ability to work independently and manage multiple priorities
- Detail-oriented
Nice to have
- Certified Professional Coder (CPC) certification through AAPC or AHIMA
- Experience with AI tools and technologies
- Psychiatric RN or Masters degree in Behavioral Health (for behavioral health roles)