customer service representative

software engineer

senior software engineer

business systems analyst

director

Cambia Health Solutions

I worked here remotely for five months and turned in my two weeks. I personally liked my supervisor. They were kind and empathetic. My coworkers were cool.  85% members were wonderful. 

Overall, this job is high stress. Management says “let yourself be new” but the fact is, members are calling and they want quick answers. This creates high pressure because essentially you are expected to provide information quickly, and confidently. Members could be asking about why their premium cost had changed, does their insurance cover a cpap machine, why their medical bill is so high, what is their deductible, does their insurance cover a specific procedure, can they list a specialist as their primary care doctor, etc. the list goes on and on. All of your work, personal quick breaks, everything on the work computer will be tracked and recorded.

Some of the most difficult calls were members being denied for specific benefits, such as physical therapy. It’s your job to give them the bad news, reading medical documentation, and telling them why they won’t be receiving this coverage. This makes some members very angry and you are the one receiving the brunt of their anger. There so so many examples where a member might be calling and they are furious. Like if their insurance didn’t cover a procedure even though they went into it thinking it did. Some members will rip you apart and make you cry, wondering how a human can do that over the phone. Just a part of the job. Most calls are great but some are really hard.

The fact is, you have to provide information and explanations quickly. This can cause major stress because a lot of the information you gain is just by working. This job requires a ton of reading/researching. That’s basically what the job is. You cannot multitask by taking care of anyone while working. This job has pressure and you have to learn to be efficient. 

The good news is, they encourage promotions. If you can be successful while pushing through  the high demanding, ever-flowing stream of calls for about a year then you could look into applying for other positions, like working in claims. I didn’t stick around long enough to experience this and I didn’t want to. 

This job isn’t for the faint of heart and it didn’t feel worth the demand to me, though I also had a lot going on in my life, so I had outside stressors. 

Starting with the onboarding process they were disorganized. The interview process for customer service requires three interviews and 6 weeks training. 
During the training we were originally 2 classes with 30 total trainees and 4 trainers. First day, a few people’s equipment didn’t work so we lost 5 trainees. Day two they merged us into one class and put two trainers on special projects leaving us with a brand new trainer on her first class . I think 10 of us finished training. Then the real fun began.
When we hit the floor we barely knew how to utilize the phone systems because the training was all theory and no practical application, despite requesting MULTIPLE times during training they let us get actual experience using the phones within the class. For me my mail account would not let me send attachments so for the first three months I had to ping a coworker on teams every time I had to email a document to members.
They kept telling us to “allow yourself to be new” while providing very little in the way of support. Their “resource desk” of trained representatives who are there to assist frontline CSP’s would have a 30 minute wait to get to a representative. They had a chat feature that helped for quick answers but they phased that out. Not to mention the multiple incorrect answers I was told to give members. 
They are somewhat manipulative in their feedback process as well. They promise no retaliation but any feedback offered is just to make the employees feel heard. They do little to adjust their systems other than have multiple team meetings to go over processes. Your supervisor will most likely be tasked for the majority of their day and unable to assist with any real urgency. 
The big lie is you will move from customer service. You will not. The turnover rate is currently around 106% and they hope to reduce that by 30% in the coming year. They are going to accomplish this by training an AI using current customer service reps to help handle calls and reduce the number of employees. 


The general consensus I felt while coming out of training til now was that Cambia hires hyper navigators or highly anxious people. If you can make sense of the work process they attempt to train you in 8 weeks then you're better off than I was. I, as others, really struggled with the material that was taught to us despite asking clarifying questions. It didn't help that we had a remote learning environment riddled with tech issues. I felt like the way they presented side-by-sides was really lacking for someone like me who needs to see all the steps of a work load to understand what to do. I loved my trainers but having this dialogue of "don't worry! I really struggled and didn't get it but it took me x amount of years to get it!", "Your classmates struggled too and some of them were experienced in benefits!" doesn't give me confidence in what the company does for it's new hires. The way you navigate programs, booklets and everything else is digital but there is no solid way of getting the right answer for anything unless you're told it critically after the fact. There are ALOT of audits/surveys. I was shocked there was no buffer for the new hires and you are audited almost immediately after you're on the phone. The work I performed did not morally align with me and I felt bad telling people with high risk health conditions that they were not covered. I cannot attest to the cliche work environment everyone else claims but my management/HR were very supportive of me during all of my time there. 

What is it like working at the company?
There is little training when you start, just basic intros to the tools that you'll be using for your daily tasks. You are thrown directly into the work with little to no foundation and the reality is that you learn as you go. Be prepared for a lot of on-the-job training.

What is the workplace culture like?
Most co-workers are friendly when you reach out. They generally attempt to answer questions and provide support if you ask them (and of course, vice versa). The team dynamic is pretty siloed. People log in to do their work and then log out. There's no team effort to get to know who your co-workers are, feeling like you're a valued part of the team, or building camaraderie.

What is management like?
Reaching out to management is a different story. More times than not, management is completely unresponsive to work concerns and employee well-being. There are department-level messages of striving for well-being and work-life balance but the reality is that it doesn't trickle down at all. They delegate unrealistic amounts of items to you and expect them all complete in a unrealistic timeframe. When you reach out to them about concerns and priorities, they don't respond at all. Then they come back later and ask you why things are stalled. This harmful cycle repeats on and on and when you feel crushed and can't do any more, the things that weren't completed get called out as "misses" in your review.

It's not a supportive dynamic. Appreciation is rarely given. They care way more about giving a presentable image to those outside the team rather than focusing on the actual factor that drives results: the employee. Burnout is common. Others in department feel the same way.

What is the most enjoyable part of the job?
The company has generally decent benefits and it offers WFH for a lot of positions (if you decide to do that).


Great place to work *until* you have been there over ten years.  At that point you need to watch over your shoulder because you will be terminated first when budget cuts occur and they always do.  Your direct manager will not have any control because they are told who to let go based on salary threshold and not based on performance.  They literally do not care about your years of service, quality and quantity of your work and knowledge of company.  I have watched this occur and you can ask any current or past employee if they know of someone this has happened to.  They will say it happens often.  There is no "dead wood" at Cambia.  Budget cuts usually cut into the bone and are not just a trim.    .    .    .So far management has guessed correctly on future direction of the company.  The Affordable Care Act was the most recent industry hurdle that took its toll on many health care companies by picking the wrong way to deal with it.  After successfully navigating that, Cambia is seeking a direction.  Upper management is putting all their eggs in one basket on Journi project that even rank and file employees can't visualize its success. Due to this, there is a developing corporate divide between those working on the bread and butter of health care insurance operations and those working on new unproven health care related operations that will not be revenue generating for many years if at all.

I enjoyed working with professionals in the medical field they ranged from Nurses, Therapist, Licensed Clinical Social Workers, Clinicians and retired Doctors. I would receive request from them to retrieve hospital readmission data and compile a report for them to review and evaluate. I Assigned members with qualifying diagnosis of Heart Disease, Renal Failure, and Respiratory Ailments to the clinical personnel for further evaluation. Reviewed medical records, prepare documents and scan for Behavioral and Case Management Clinicians. Maintain Case Managers reports such as Future Risk Cost, High Risk Pregnancies, and Productivity reports.
Data mined large quantities of data to identify high risk utilizations and route candidates to specific programs. Supported Personal Care staff by researching clinical data, contractual benefits, and reviewing Hospital Readmission Daily Census reports. Responded to request for history of  controlled substance and pharmacy data and produced a reports for clinical and utilization clinicians to review. Compile monthly productivity totals and utilize data mining software to produce monthly reports for management to review. Post service claim review, communicated processing instructions pertaining to Providers or Facilities contracts. I learned medical terminology, how to read CPT and ICD codes. The most enjoyable part of my job was finding members to assign to Case Management where they would receive the appropiate level care by a licensed Nurse or Licensed Clinical Social Worker. The hardest part of my job was analyzing large amounts of data and sitting for long periods of time.

I worked as a review nurse in one of their  program. Honestly , I felt that the training was fragmented and inefficient. I was assigned to a person who was not available most of the time since she was also doing her load of work while training me. System used is difficult and fragmented in the processing, intake people kept sending you IM to take a call while you were still on the phone with other clients , and you need to respond to them by IM while maintaining an ongoing medical review (while typing the information) or the supervisor will give you hell. The phone never stop ringing...and I had to stay 2 hours beyond my 8 hours with no overtime to finish the entry in my computer and this nightmare was a daily basis. I did not know I signed up for this " court stenographer job". I type fast, but I did not sign for this review and type all at one time. The extreme multi - tasking was self defeating the quality of the work. The supervisor was not supportive and have been there forever and have an antiquated approach to management. 
They failed all of their Medicare regs and eval..... I am making a guess this is due to understaffing and mismanagement.
The pay and the benefits were excellent, minus the management and the training process. I believe that there was some racial stuff as well.
The environment was gloomy and not as friendly..... noted some unhappy and stressed out employees.
The interview was a lie, or I would not have taken this job in the first place If knowing from the above.........

Cambia embraces new ideas and experiences that employees bring from previous job or schooling. The culture values hard work, however, there is flexibility around hours as needed or working remotely. There is an open atmosphere for sharing information, good or bad news, because of the continuous improvement direction. Since I'm in Operations, first thing I do every day is to check for system performance and how my team(s) need to engage in issues. We have a morning Management Stand-up that give a great overview of the previous day's performance so we can organize to address those issues that are slowing customer service reps, claims processors, sales representatives so impacts to productivity are minimal. Then, we work on the improvement projects that are clearly set in the Quarterly Goals. Upper Management is readily available to remove barriers to making improvement. Cambia is in a formative state do to changes and plans brought about due to the Affordable Care Act, and seem a little behind the curve on this. Recently they have be adding a relatively high number of C-Level employees that puzzles the rank and file as we continue focus on cost reductions. Overall, the Cambia Cause to create more transparency and sustainability to the health care market is highly motivating, and we feel aligned and energized by it.

Cambia provided 3 months of training for a specialized role handling claims where trainer read from a script for 8 hours a day. Nothing covered in training was actually applicable to what we would do for the role. Unless you had prior knowledge of medical claims, the training was useless. My training class was overwhelmed with how many roles we were put into, while new and people with seniority only worked 1 line of business.

When there was a system outage the company tried forcing us to make up the hours, even though our employee handbook stated they had to pay us for scheduled hours during system outages. Upon complaining they reversed course and demanded we work overtime to cover the lost time, without overtime pay. They consistently demanded mandatory overtime with only a few days notice, requesting we work 10-15 hours extra per month. 

Upon resigning, they did not pay me correctly, leaving me to request they pay me correctly on two separate occasions: holiday pay and hours that I actually worked prior to resigning. Had I not requested my final pay stub, they likely would have not paid me for that time. 

The work from home, flexible schedule was nice but not worth the stress of the role and very low (unlivable) wages.

I started out working at Cambia many years ago in their Inside Sales department and it was a great place to work — the employee culture and team unity was high and the company ensured we were highly trained with excellent product and industry knowledge, enabling us to be a valuable resource for current and prospective members. 

In my humble opinion, I feel that gave Cambia a distinct advantage in that the Inside Sales department was quite often the very first touch point prospective members would have with our company. Being greeted with employees who can confidently answer questions and address concerns and additionally educate customers to empower them to make informed choices — there is no way someone reading a script or following a flow chart, mailing a sales packet and ending with weak assurance that someone somewhere will be contacting them sometime to discuss their options further is going to instill confidence or exude top notch service. 

Towards the end of my time at Cambia the organization came to feel like they were cutting corners wherever possible for the sake of shaving off a few cents here or there. Being fiscally conscious isn’t the same as hacking off chunks of the organization without awareness or consideration of the overall added value they provided. 

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