Support Services Specialist

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.

• 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.