Claims Resolution Associate

Collective Health - Lehi, UT

Full-time
Collective Health is transforming the way people experience healthcare. We believe that quality and accuracy are paramount to ensuring exceptional member and employer experiences, and that the foundation for analytics can change how we deliver and pay for care. To accomplish this, we are reimagining the operational core of health insurance.

Additionally, Collective Health is expanding its Operations team in Lehi, Utah! As a Claims Resolution Associate, you will be a founding member of Collective Health's Plan Operations team. In this role, you will be tasked with reviewing complex medical claims and resolving issues with these claims across both internal and external claims processing systems.

What you'll do:
Independently review, input and process complex medical claims in accordance with assigned Plans, ensuring that high quality and timeliness standards are met
Perform routine administrative and clerical tasks to track claims data
Become an expert in complex cross system resolution and work with other Operations team members to ensure inventory meets our timeliness requirements
Collaborate, advise and train other Operations team members on the claims resolution processes and intricacies
Participate in periodic trainings to remain current on procedures and claims processing resources
Gain in-depth industry expertise in medical claims, reimbursements, and the employer-driven healthcare economy
Cultivate a culture that aligns with Collective Health values and incorporates the unique aspects of our team

About you:
Above all, you are self-motivated, intellectually curious, and take ownership for everything you do
You pay extreme attention to detail
You have strong operational and working knowledge of claims adjudication principles and procedures
You are interested in using technology to improve healthcare
You are a committed team player
You are excited to build and adapt to the adventures of working for a rapidly expanding company
You possess a passion for Collective Health's mission to transform the health insurance experience for employers and their employees
You have 1+ years of experience as a Claims Processor or Claims Examiner (Bachelor's degree preferred but not required)
Collective Health is a technology company simplifying employer healthcare to make health insurance work for everyone. With more than 200,000 members and over 45 enterprise clients—including Pinterest, Red Bull, Restoration Hardware, Activision Blizzard, and more—our technical and customer experience teams are reinventing the healthcare experience for forward-thinking employers and their people across the U.S.

Collective Health is headquartered in San Francisco, CA, with additional offices in Chicago, IL, and Lehi, UT. Founded in 2013, Collective Health is backed by the SoftBank Vision Fund, DFJ Growth, PSP Investments, NEA, GV, G Squared, Founders Fund, Maverick Ventures, Mubadala Ventures, Sun Life, and other leading investors. For more information, visit us at https://www.collectivehealth.com

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