Customer Service Ambassador

Cambia Health Solutions

. Serve as the Partners in Care department's subject matter expert .

Posted 10/1/2026full-timeRemote • United StatesMid-LevelSenior💰 $24 - $42 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in member service operations, including claims resolution, benefit administration, and regulatory compliance. Proficient in coaching and mentoring customer service staff while analyzing data trends to enhance service delivery.

Highest-signal resume keywords

Member Service ExperienceClaims ResolutionData AnalysisCoaching and MentoringRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingBenefit AdministrationData Trend AnalysisIssue ResolutionGrievance and Appeal Processes

Soft Skills

DependabilityMember FocusProvider FocusInterpersonal Communication

Tools & Technologies

AI Tools and Technologies

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Customer ServiceHealthcareCoordination of BenefitsPolicy Compliance

About the role

Key responsibilities & impact

Serve as the Partners in Care department's subject matter expert
Support and coach Customer Service staff
Handle and resolve escalated and complex calls, claims, and inquiries from members, providers, employer groups, and healthcare professionals
Research and resolve claims, benefit administration errors, appeals, and correspondence issues according to company policy and regulations
Explain benefits, eligibility, claims procedures, pre-authorizations, and grievance/appeal processes
Coach, mentor, and support Customer Service staff through one-on-one guidance, help line support, training, and onboarding
Collaborate with Medical, Legal, Provider Relations, Claims, and Pharmacy Services
Analyze data and trends to identify recurring issues
Provide ongoing education and recommendations to Customer Service leadership
Ensure issue resolution aligns with corporate policy and regulatory requirements
Serve as subject matter expert on company policies, products, processes, and Coordination of Benefits

Requirements

What you’ll need

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
Ability to report, analyze, and identify data trends to develop courses of action and evaluate outcomes
Ability to accurately assess member inquiries and requirements, establish rapport, identify errors, and determine corrective steps
Dependability, member and provider focus, and adherence to departmental performance criteria
Experience with AI tools and technologies highly desired
Work-from-home setup with wired internet that is not satellite or cellular, minimum 5 Mb upload and 10 Mb download speeds
Access to a personal mobile device for MFA setup
Successful background check required

Benefits

Comp & perks

5% bonus target
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 varying by role and tenure
10 company-paid holidays
Market-leading retirement plan including 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, subject to eligibility
Award-winning wellness programs that reward participation
Employee Assistance Fund
Commute and parking benefits
Flexible work-from-home options
Employee resource groups
Cambia-supported community outreach opportunities
Required wired internet connection and minimum internet speeds for work-from-home arrangements
Personal mobile device access for Multi-Factor Authentication