[Hiring] Processing Specialist I - Special Processing @Businessolver

Role Description

The Processing Specialist I - Special Processing 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
• 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.

The Gig:

• 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.
• 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.

Qualifications

• 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.

Requirements

• The pay for this position is $18.50 per hour.
• 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 .

Equal Opportunity at Businessolver

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.