This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Support Services Specialist based in the United States.
As a Support Services Specialist, you will play a key role in delivering an outstanding support experience to healthcare members and providers. You will serve as a primary point of contact, helping individuals navigate their healthcare benefits, eligibility, claims, and authorizations. Through clear communication, empathy, and effective problem-solving, you will ensure that inquiries are handled accurately and efficiently. You will collaborate with cross-functional teams to resolve complex issues and provide guidance on healthcare plans, policies, and digital resources. This is an opportunity to contribute to a growing, technology-driven healthcare environment focused on improving access to care and simplifying healthcare administration. You will also help strengthen support operations while delivering meaningful value to members and providers.
Accountabilities:
- Handle inbound calls from healthcare members and providers, delivering professional, empathetic, and solution-oriented assistance.
- Provide accurate information and guidance regarding healthcare benefits, eligibility, claims status, authorizations, and network participation.
- Investigate and resolve complex inquiries by coordinating with internal teams and relevant stakeholders.
- Educate members and providers on healthcare plan policies, digital tools, available resources, and support processes.
- Identify issues requiring additional assistance and escalate them appropriately to ensure timely and effective resolution.
- Protect sensitive information and maintain strict confidentiality in accordance with HIPAA regulations and applicable privacy requirements.
- Consistently meet or exceed performance expectations related to call quality, response times, accuracy, and customer satisfaction.
- Contribute to the continuous improvement and development of support operations as the organization expands and takes on new challenges.
Requirements:
- Previous experience in customer support, member services, provider services, healthcare administration, or a related field.
- Strong verbal and written communication skills, with the ability to explain complex information clearly and professionally.
- Excellent interpersonal skills, including empathy, active listening, and a genuine commitment to delivering high-quality service.
- Strong attention to detail and a consistent focus on accuracy when handling sensitive information and resolving inquiries.
- Excellent problem-solving and critical-thinking abilities, with the capacity to investigate issues and identify effective solutions.
- Ability to prioritize multiple responsibilities and manage workloads efficiently in a fast-paced, detail-oriented environment.
- High levels of dependability, accountability, integrity, and professionalism.
- A collaborative mindset and the ability to work effectively with cross-functional teams.
- Familiarity with HIPAA regulations, CMS guidelines, or managed care practices is an advantage.
- Experience with innovative healthcare plan models, including Reference-Based Pricing (RBP), cash payment models, and employer-sponsored Direct Primary Care, is considered a strong asset.
- Bilingual proficiency, particularly in Spanish, is a plus.
Benefits:
- Competitive annual salary ranging from $48,000 to $55,000, depending on experience, location, and desired equity.
- Equity opportunities.
- Comprehensive health benefits.
- 401(k) retirement plan with employer matching contributions.
- Fully remote working arrangement, offering flexibility in where you work.
- Career development and professional growth opportunities.
- Opportunity to contribute to an innovative and evolving healthcare environment.
- High-trust working culture built on transparency, autonomy, and collaboration.
- Regular working schedule: Monday to Friday, 9:00 AM to 6:00 PM EST.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
#LI-CL1
