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Businessolver
United States · remote · USD 18.5-18.5 hourly
Since 1998, Businessolver has delivered market-changing benefits technology and services supported by an intrinsic responsiveness to client needs. The company creates client programs that maximize benefits program investment, minimize risk exposure, and engage employees with easy-to-use solutions and communication tools to assist them in making wise and cost-efficient benefits selections. Founded by HR professionals, Businessolver's unwavering service-oriented culture and secure SaaS platform provide measurable success in its mission to provide complete client delight.
The Special Processing Specialist II provides advanced HR support focusing on benefit processing, compliance, and member services. Responsible for managing complex cases including condolence management, QMCSO compliance, benefit appeals, POA documentation, and Medicare L564 requests. Ensures accuracy, compliance with HIPAA, IRS, and CMS regulations, and maintains workflow continuity. Supports process improvements and mentors junior staff. Requires professional communication with members, teams, and partners, handling escalations and reporting activities.
Review and process appeals, condolences, QMCSO orders, Medicare L-564 forms, and POA requests accurately.
Verify eligibility and manage elections, record updates, and coverage activation per SOPs.
Submit life and disability claims timely with complete and correct information.
Apply client-specific requirements across multiple workstreams.
Provide proactive, accurate, and empathetic support to enhance member experience.
Communicate professionally with members, internal teams, and external partners.
Maintain compliance with HIPAA, IRS, CMS regulations and manage mandated notices and documentation.
Identify and resolve documentation or process issues using critical thinking and compliance standards.
Apply on source siteListed via Himalayas
Protect sensitive data and maintain transaction integrity.
Meet attendance and performance goals; take ownership through task resolution.
Handle escalations, assist during client calls, and prepare activity and performance reports.
Participate in daily stand-ups and foster team collaboration.
Bachelor’s degree preferred in Human Resources, Business Administration, or related field.
2–3 years experience in HR operations or employee support.
Strong knowledge of benefits processing and compliance requirements.
Proficiency with HRIS and Microsoft Office.
Excellent attention to detail and ability to manage confidential information.
Strong communication skills and ability to work collaboratively while adhering to HIPAA, IRS, and CMS regulations.
The pay for this position is $18.50 per hour(pay to be determined by the applicant’s education, experience, knowledge, skills, abilities, balanced against internal equity and competitive market based geographic ranges).
Other Compensation: If this position is full-time or part-time benefit eligible, you will receive a comprehensive benefits package which can be viewed here:
At Businessolver, we take our responsibility to protect our clients, employees, and company seriously and that begins with the hiring process.
Our approach is thoughtful and thorough. We’ve built a multi-layered screening process designed to identify top talent and ensure the integrity of every hire. This includes quickly filtering out individuals who may attempt to misrepresent themselves or act in bad faith.
We also partner with trusted, best-in-class providers to conduct background checks, verify identities, and confirm references. These steps aren’t just about compliance, they’re about ensuring fairness, safety, and trust for everyone involved.
Put simply: we will always confirm that you are who you say you are. It's just one of the many ways we uphold the standards that matter most, to you, to us, and to the people we serve.
With heart,
The Businessolver Recruiting Team
Businessolver is committed to maintaining an environment that protects client data. We train our employees to maintain leading class security practices and expect all employees to adhere to policy, procedures and controls.
(Applicable to all roles at an AVP, DIR, VP, Head Of or SVP and above level):
Serve as a security contact for the business unit. Responsible for driving adoption and compliance with information security and privacy practices. Serve as a liaison with the information security team on security and privacy matters.
Businessolver is an Affirmative Action and Equal Opportunity Employer and is proud to offer equal employment opportunity to everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, veteran status, and more. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.
Originally posted on Himalayas