Processing Specialist I - Special Processing (Remote)

At Businessolver, we believe benefits should be easy for everyone. We combine intelligent technology with human expertise to help organizations anticipate needs, simplify complexity, and create better experiences for employees and HR teams alike. Our people-first culture is built on innovation, accountability, and a shared commitment to delivering meaningful outcomes for the clients and communities we serve. Every role at Businessolver contributes to our mission of helping people thrive through benefits experiences that are smarter, simpler, and more human.

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, 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.

 

The Gig:

 

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Review and process appeals, condolences, QMCSO orders, Medicare L-564 forms, and POA requests accurately.

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Verify eligibility and manage elections, record updates, and coverage activation per SOPs.

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Submit life and disability claims timely with complete and correct information.

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Apply client-specific requirements across multiple workstreams.

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Provide proactive, accurate, and empathetic support to enhance member experience.

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Communicate professionally with members, internal teams, and external partners.

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Maintain compliance with HIPAA, IRS, CMS regulations and manage mandated notices and documentation.

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Identify and resolve documentation or process issues using critical thinking and compliance standards.

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Protect sensitive data and maintain transaction integrity.

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Meet attendance and performance goals; take ownership through task resolution.

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Handle escalations, assist during client calls, and prepare activity and performance reports.

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Participate in daily stand-ups and foster team collaboration.

 

What you need to make the cut:

 

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Bachelor’s degree preferred in Human Resources, Business Administration, or related field.

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2–3 years experience in HR operations or employee support.

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Strong knowledge of benefits processing and compliance requirements.

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Proficiency with HRIS and Microsoft Office.

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Excellent attention to detail and ability to manage confidential information.

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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. 
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: https://businessolver.foleon.com/bsc/job-board-businessolver-virtual-benefits-guide/  

Dear Applicant.  

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.   

Along the same lines, p lease be aware of recruitment scams. Businessolver does not make job offers outside of our official hiring process or request payment or sensitive personal information.  You will never receive an offer of employment without meeting a hiring authority and having a "live" and face-to-face conversation.  

With heart,

The Businessolver Recruiting Team

#LI-Remote