Claims Operations Associate Claims Performance & Resolution
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Job Location:
Monthly Salary:
Posted on:
18-09-2025
Vacancies:
1 Vacancy
Job Summary
At Collective Health were 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 youll work on claims systems issues Ingenuity testing and development.
What youll 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.
To be successful in this role you:
- Previous experience working with 835 files
- 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 Healths mission to transform the health insurance experience for employers and their employees
Pay Transparency Statement
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 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 athttps:// UT Pay Range
Key Skills
- Corporate Paralegal
- Baan
- IT Sales and Marketing
- Civil Quality Control
- Activex
- Jboss
About Company
Collective Health offers the first integrated solution that empowers employers to administer plans, manage costs, and take care of their people—all in one place.
