Provider Electronic Data Specialist I

Posted 6 Days Ago
Be an Early Applicant
14 Locations
In-Office
24-42 Hourly
Junior
Fitness • Healthtech
The Role
Provide remote provider support for EDI/EFT enrollments and Availity portal issues. Validate and process EFT enrollments, document incidents in Remedy, resolve Availity escalations, perform EFT testing, maintain internal documentation and shared inboxes, and meet service level agreements while supporting internal and external customers.
Summary Generated by Built In

Provider Electronic Data Specialist I

Work from home within Oregon, Washington, Idaho, or 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 Provider Electronic Data Specialists are living our mission to make health care easier and lives better. As a member of the Provider Contracting and Business Operations team, the Provider Electronic Data Specialist will support use of Electronic Data Interchange (EDI) technology in the provider community to facilitate EDI functions and automatic data processing solutions to increase our value to the provider community.

Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia: 

Qualifications:  

The Provider Electronic Data Specialist I would have a Bachelor’s Degree and 1+ years of experience in Provider Customer Service or technical Help Desk environment or equivalent combination of education and experience.

Skills and Attributes: 

  • Attention to detail, administration and demonstrated organizational skills required.

  • Proficient in the use of many technical tools and knowledgeable of many systems running on a variety of computer/network platforms.  Knowledge in the use of basic PC hardware,  applications/tools, desktop operating systems, advanced hardware, and software functionality, Availity Essentials etc.

  • Excellent problem-solving processes analysis, communication, and people skills.

  • Demonstrates the ability to work independently, with team members and other departments .

  • Conceptual understanding of electronic data interchange (EDI) technology as it applies to health care transactions, including ANSI format knowledge.

  • Ability to make determinations quickly and work well under pressure. 

  • Ability to maintain a positive and constructive attitude.

  • Demonstrates ability adapt to change and work effectively in a dynamic work environment.

  • Excellent communication skills, a positive phone presence and unwavering commitment to customer service are essential.

What You Will Do at Cambia: 

  • Fields, answers or refers customer inquiries for problem resolution about EFT enrollments

  • Performs EFT validation calls, processes and updating Transaction Enrollment tool on Availity Essentials.

  • Updates/maintains internal documents pertaining to EFT enrollment and validation process.

  • Responsible for researching and resolving Availity escalation issues that involve the provider portal function and display of information.  Works closely with the business and product owners to help research and resolve issues.

  • Documents all internal EFT customer-reported problems via Remedy and Escalation Tickets.

  • Adheres to service level agreements for both internal or external customer

  • Responsible for customer support through direct interaction with internal/external customers by telephone, email, Remedy tickets, Availity Client Service tickets, etc.

  • Serve as a support resource internally and externally.

  • Accountable for completion of tasks, problem resolution, EFT reporting, maintaining EFT shared email inbox, etc.

  • Perform EFT testing when required.

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 $24.40 - $32.40/hour, the full salary range is $24.40 - $42.20/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.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Skills Required

  • Bachelor's degree or equivalent combination of education and experience
  • 1+ years experience in Provider Customer Service or technical Help Desk environment
  • Conceptual understanding of Electronic Data Interchange (EDI) technology and ANSI format knowledge
  • Proficiency with Availity Essentials and Availity portal functions
  • Experience using Remedy (ticketing) and managing escalation tickets
  • Familiarity with Transaction Enrollment tools and EFT validation processes
  • Strong attention to detail, organizational and problem-solving skills
  • Excellent verbal and written communication skills and positive phone presence
  • Ability to work independently and collaboratively across teams
  • Ability to adapt to change and work effectively in a dynamic environment
  • Maintain a wired home internet connection (not satellite/cellular) with minimum upload 5 Mb and download 10 Mb
  • Access to a personal mobile device to set up Multi-Factor Authentication (MFA)
  • Work from home within Oregon, Washington, Idaho, or Utah
  • Background check required
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The Company
HQ: Portland, OR
4,123 Employees

What We Do

Cambia Health Solutions is a family of companies headquartered in Portland, Oregon, working to create a person-focused and economically sustainable healthcare system. Discover how Cambia’s dedication to cutting-edge innovation and positive transformation is helping change the healthcare industry. Through our health plans, innovative technology and strategic investments, we are delivering consumer-centric solutions that: • help people achieve better health and well-being • make health care more available, affordable and accessible • are easily understood by everyone We put people at the heart of everything we do. Our company reaches more than 70 million Americans nationwide, including more than two million people in the Pacific Northwest who are enrolled in our regional health plans.

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