Support Services Specialist

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

📋 Description

• Professionally and courteously respond to incoming calls from members and providers.

• Supply accurate details concerning benefits, eligibility, claims status, authorizations, and network participation.

• Investigate and address complex inquiries through collaboration with internal departments.

• Inform members and providers about plan policies, digital resources, and available tools.

• Appropriately escalate issues to ensure prompt resolution.

• Uphold confidentiality and comply with HIPAA regulations.

• Achieve or surpass performance metrics related to call quality, responsiveness, and customer satisfaction.

• Contribute to the development and enhancement of the Support team as it grows.

• Act as the initial point of contact for members and healthcare providers, delivering phone-based assistance.

⛳️ Requirements

• Experience with innovative health insurance plan structures, such as Reference-Based Pricing (RBP), cash payment models, and employer-sponsored Direct Primary Care.

• Knowledge of HIPAA, CMS, or managed care guidelines.

• Demonstrated empathy and active listening skills.

• Strong dedication to precision and attention to detail.

• Proficient in prioritizing tasks effectively in a dynamic environment.

• Excellent communication abilities.

• Strong problem-solving and critical thinking skills.

• Reliability and accountability in work performance.

• Team-oriented attitude.

• Bilingual proficiency, particularly in Spanish, is advantageous.

• Availability to work Monday through Friday, from 9am to 6pm EST.

• Must indicate whether sponsorship will be necessary to work in the United States.

🏝️ Benefits

• Opportunities for equity ownership.

• Comprehensive health benefits.

• 401K plan with employer matching.

• Opportunities for career advancement and development.

• Options for remote work.

• A high-trust team culture characterized by exceptional transparency and autonomy.