Special Processing Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate and process appeals, condolences, QMCSO orders, Medicare L-564 forms, and POA requests.

• Confirm eligibility and oversee elections, record modifications, and coverage initiation in accordance with SOPs.

• Accurately submit life and disability claims within specified deadlines.

• Implement client-specific requirements across various workstreams.

• Deliver proactive, precise, and compassionate support to members.

• Maintain professional communication with members, internal teams, and external partners.

• Ensure compliance with HIPAA, IRS, and CMS regulations.

• Manage mandated notices and documentation efficiently.

• Identify and address documentation or process-related issues.

• Safeguard sensitive data and uphold transaction integrity.

• Achieve attendance and performance targets while taking ownership of task resolution.

• Manage escalations, assist during client calls, and compile activity and performance reports.

• Engage in daily stand-ups and promote team collaboration.

• Contribute to process enhancements and mentor junior team members.

⛳️ Requirements

• Bachelor’s degree preferred in Human Resources, Business Administration, or a related discipline.

• 2–3 years of experience in HR operations or employee support.

• In-depth knowledge of benefits processing and compliance standards.

• Proficient in HRIS and Microsoft Office applications.

• Exceptional attention to detail and capability to handle confidential information.

• Strong communication abilities and a collaborative work ethic.

• Capacity to comply with HIPAA, IRS, and CMS regulations.

• Must successfully pass background checks, identity verification, and reference checks.

🏝️ Benefits

• Comprehensive benefits package available for benefit-eligible full-time or part-time employees.

• Security and privacy training provided.