Special Processing Specialist II (Remote)
Core
Advanced HR support focusing on benefit processing, compliance, and member services for complex cases including appeals, condolences, and Medicare requests.
Role type
Senior HR operations specialist (benefits processing)
Builds
Accurate benefit claims processing and compliance reporting for members
Domain
Human Resources / Benefits Administration
Deliverable
client delivery
Required skills
Benefits processing, HIPAA/IRS/CMS compliance, HRIS proficiency, claim submission, eligibility verification, documentation management
Preferred skills
Process improvement, mentoring junior staff, critical thinking
Technologies
HRIS, Microsoft Office
Responsibilities
Review and process appeals, condolences, QMCSO orders, Medicare L-564 forms, and POA requests; Verify eligibility and manage elections, record updates, and coverage activation; Submit life and disability claims timely; Identify and resolve documentation or process issues; Handle escalations and prepare activity reports
Seniority
Mid-level, hands-on IC