Claims Operations Associate - Policy Operations (Contract)

Job description

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 owns specialized processes that require close collaboration with finance, legal, product, and other internal teams. As a Contractor of the Claims Operations team, you will be responsible for the execution of workflows that are closely tied to legal including client plan exceptions, gap exceptions, subrogation, out-of-network pricing and more. You will be responsible for the development of policies & procedures that enable successful operations and ensure operational compliance on the Member Claims team as well as other teams within Health Plan Operations (HPO). What you'll do: - Support the execution of the day-to-day operations of our medical plans, including but not limited to: - Coordinating with third parties such as, Subrogation partners, and medical network partners, etc. - Triaging & actioning member gap exception requests - Resolving Subrogation reports and complex inquiries t...