Claim Operations Associate II

Описание вакансии

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 Claims team within Health Plan Operations, the Plan Operations team will own processes that require close collaboration with finance, legal, product, and other internal teams. The Plan Operations - Systems 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, and accumulator reconciliations. 

What you'll do:

• Support the execution of the day-to-day operations of our medical plans, including but not limited to:
• Resolving errors related to medical 835 forms and claim finalization
• Triaging & troubleshooting claim processing related bugs and issues
• Loading 837s and one off claims into our claims network via the manual load process
• Own & apply a scalability lens to several key areas surrounding our manual 835 error resolution process
• Assist in research and improvement of our 835 integrations
• Identify and lead quality/process improvement projects within Claim Operations and across CX.
• Build (and/or work with the development team to build) internal tools to improve processes as we identify and fix problems relating to claims adjudication
• Collaborate cross-functionally with Member Claims, Legal, Product, Development, and Product Operations teams to delight our customers

To be successful in this role, you'll need:

• At least 2-5 years of claims payment or claim operations experience.
• Familiarity with X12 837 and 835 standards
• To have working knowledge of claims workflows and associated processes
• To pay extreme attention to detail
• To enjoy connecting the dots & communicating complexities
• To be excited about reimagining how we structure our body of work to align with the new service design
• To be a strong performers within your current role
• To be a committed team player
• To thrive on change and are enthusiastic about being along for the ride and learning from our experiences together
• A passion for Collective Health’s mission to transform the health insurance experience for employers and their employees

Pay Transparency Statement

This is a hybrid position based out of one of our offices: Plano, TX, or Lehi, UT. Hybrid employees are expected to be in the office three days per week (Plano, TX) or two days per week (Lehi, UT).#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 10,000 stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.

Lehi, UT Pay Range

$27.20—$34 USD

Plano, TX Pay Range

$29.85—$37.40 USD

Why Join Us?

• 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 recruiting-accommodations@collectivehealth.com.

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