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Job Description
Healthcare Service & Operations Specialist Should have good knowledge in customer support and claims We are looking for someone who: Knows the healthcare business and can navigate complex situations with confidence Can act as a bridge between our members and their healthcare benefits Goes beyond customer service to bring real industry knowledge to the role
Responsibilities:
Handle benefit coverage questions, claims, and authorizations Manage member relationships to support retention Clearly explain insurance concepts to members and providers
Requirements:
Solid understanding of how claims, liabilities, and insurance coverage work Calm under pressure, thoughtful rather than reactive Strong communication skills, both on the phone and in writing Basic comfort with business systems and databases