At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.
As part of the Services Ops team within Customer Experience, the Claim Operations team will own processes that require close collaboration with finance, legal, product, and other internal teams. The Claims Operations - Claims Performance and Resolution team ensures our production systems are working accurately and partners with our Product team to resolve issues that arise. As a member of the team, you’ll work on claims systems issues, Ingenuity testing and development.
What you'll do:- Support the execution of the day-to-day operations of our medical plans.
- Identify areas of 835 improvement in order to limit return file errors
- Triage & troubleshoot claims related issues (file ingestion, data sync, etc)
- Support System functionality
- Apply a scalability lens to several key areas in Claim Operations – Ingenuity development, Claims Response Unit (CRU), Systems Health and more
- Assist in the development of our internal claims engine, Ingenuity
- Assist in developing claim Pend rule criteria, Pend rule testing scenarios and monitoring Pend rule performance within Ingenuity
- Identify and lead quality/process improvement projects within Claim Operations and across Service Ops/CX
- Build (and/or work with the development team to build) internal tools to improve processes as we identify and fix problems
- Collaborate cross-functionally with various internal teams.
- Are self-motivated, intellectually curious, and take ownership for everything you do
- Have working knowledge of claims workflows and associated systems
- Pay extreme attention to detail and enjoy connecting the dots & communicating complexities
- Are excited about reimagining how we structure our body of work to align with the new service design
- Are a strong performer within your current role
- Thrive on change and are enthusiastic about being along for the ride and learning from our experiences together
- Possess a passion for Collective Health’s mission to transform the health insurance experience for employers and their employees
This is a hybrid position based out of our Lehi office, with the expectation of being in office at least two weekdays per week. #LI-hybrid
The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the hourly rate, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.
- Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare
- Impactful projects that shape the future of our organization
- Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests
- Flexible work arrangements and a supportive work-life balance
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact [email protected].
Privacy NoticeFor more information about why we need your data and how we use it, please see our privacy policy: https://collectivehealth.com/privacy-policy/.
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What We Do
Collective Health is a technology company simplifying employer healthcare to make health insurance work for everyone. With more than a quarter million members and over 60 enterprise clients—including Pinterest, Restoration Hardware, and more—our technical and customer experience teams are reinventing the healthcare experience for employers and their people.
Why Work With Us
Collective Health has a mighty mission—to make the American healthcare system effortless—and a culture focused empathy, authenticity, curiosity, and a need to solve hard problems. We have a diverse, mission-driven team with doctors working alongside data scientists and nuclear engineers to reinvent the the healthcare experience for everyday people.
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