Eligibility Operations Specialist

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 are the foundation for analytics that change how we deliver and pay for care. To accomplish this, we are reimagining the operational core of health insurance.

Eligibility flows through and impacts every aspect of the Collective Health platform; each day we process inbound files from our clients to support our internal plan operations and to pass through to our networks and partners. We are looking for an Operations Specialist to be responsible for the operation, quality, and scaling of our inbound eligibility systems. You will be the integral first point of connection for the clients’ data, enabling a critical piece of our day to day operations. Through your experiences at Collective Health, you will be a pivotal part of improving the member and employer healthcare experience.

About you:

  • Bachelor's degree and 3+ years of work experience, preferably in operations, client services, or at a startup
  • Meticulous attention to detail and technical acumen (no coding experience required)
  • Experience with project management, client implementations, and/or issue resolution
  • Experience with healthcare EDI formats, COBRA, and benefit administration platforms preferred but not required
  • Strong drive: set and meet aggressive deadlines, work cross-functionally to identify and solve problems, and prioritize work
  • Demonstrated experience learning large volumes of information quickly, combined with the ability to understand bigger picture
  • Independence: must be able to build out processes and create structure with minimal guidance

What you'll do:

The Eligibility Operations Specialist will own the success of day-to-day eligibility transactions from your set of clients and their vendors and:

  • Learn and apply a deep understanding of healthcare EDI specifications, benefit administration/human resource information systems, COBRA requirements, and operational processes
  • Investigate and resolve daily exceptions and errors, raising to our clients as required
  • Work closely with Operations, Product, Engineering, and 3rd party partners on improving existing integrations and implementing new integrations (defining requirements, running file testing, etc)
  • Partner with client success to continuously improve the data at its source, drive client engagement and reporting, and to define the long-term vision for our client products
  • Prioritize quality and building for scale - our team is growing fast so you’ll need to be ready for new challenges

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. 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.


Meet Some of Collective Health's Employees

Erica H.

Senior Software Engineer

After a member visits their doctor or fills a prescription, Collective Health ensures members are billed accurately and providers are paid. Erica leads the development of the interface that enables the Operations Team to quickly and accurately process claims—ensuring money flows to the right people.

Henning C.

Director of Data Products

In the past, benefits teams have drowned in data and processes. Henning leads the development of the technical infrastructure and applications that make it easy for Collective Health’s clients to manage and optimize their employees’ health benefits.


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