Special Processing Specialist II (Remote)

Summary

Businessolver provides benefits technology and services supported by a secure SaaS platform and a service-oriented culture. The Special Processing Specialist II provides advanced HR support focused on benefit processing, compliance, and member services while managing complex cases, maintaining regulatory compliance, and supporting process improvements and team collaboration.

Responsibilities

• 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

Skills

• 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
• Bachelor's degree preferred in Human Resources, Business Administration, or related field

Qualifications

Must Haves

• 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

Nice to Haves

• Bachelor's degree preferred in Human Resources, Business Administration, or related field

Benefits

• If this position is full-time or part-time benefit eligible, you will receive a comprehensive benefits package.