Redpoint

As part of the Member Services team within Customer Experience, the Claim Operations team will own processes that require close collaboration with finance, legal, product, and other internal teams. The Claim 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, claims testing and development, and 835 error resolution.

Collective Health is a technology company working to create the healthcare experience we all deserve. Founded in 2013, our team of engineers, designers, product managers, and actuaries are redefining the $1 trillion market of employer-sponsored health benefits with data-driven and people-focused products. Our complete health benefits solution helps great companies like Activision Blizzard, Palantir, Restoration Hardware, and Pinterest take care of their people by harnessing the power of design and technology. Based in San Francisco, CA, we’re backed by some of the best investors in Silicon Valley including Google Ventures, Founders Fund, NEA, and Redpoint Ventures. Everyday, Collective Health works to create a diverse, inclusive workplace where employees can grow their careers, which is why we were recently named one

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:

• Above all, you are self-motivated, intellectually curious, and take ownership for everything you do
• At least 2 to 5 years of claim operations experience
• Familiarity with X12 837 and 835 standards
• You have working knowledge of claims workflows and associated processes
• You pay extreme attention to detail
• You enjoy connecting the dots & communicating complexities
• You are excited about reimagining how we structure our body of work to align with the new service design
• You are a strong performer within your current role
• You are a committed team player
• You thrive on change and are enthusiastic about being along for the ride and learning from our experiences together
• You possess 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 our Lehi, UT office. Hybrid employees are expected to be in the office 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 stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.