Businessolver Logo

Businessolver

Special Processing Specialist II (Remote)

Posted 6 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in United States
19-19 Hourly
Junior
Remote
Hiring Remotely in United States
19-19 Hourly
Junior
Processes complex employee benefits cases, including appeals, QMCSO orders, Medicare L-564 forms, POA requests, condolences, eligibility updates, and claims. Ensures compliance with HIPAA, IRS, and CMS requirements, protects sensitive data, resolves documentation issues, manages escalations, prepares reports, supports members and partners, and mentors junior staff while contributing to process improvements.
The summary above was generated by AI

Since 1998, Businessolver has delivered market-changing benefits technology and services supported by an intrinsic responsiveness to client needs. The company creates client programs that maximize benefits program investment, minimize risk exposure, and engage employees with easy-to-use solutions and communication tools to assist them in making wise and cost-efficient benefits selections. Founded by HR professionals, Businessolver's unwavering service-oriented culture and secure SaaS platform provide measurable success in its mission to provide complete client delight.

**Please 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.**

The Special Processing Specialist II 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:

  • 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.


What you need to make the cut:

  • 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.


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. 

With heart,
The Businessolver Recruiting Team

Businessolver is committed to maintaining an environment that protects client data. We train our employees to maintain leading class security practices and expect all employees to adhere to policy, procedures and controls.

(Applicable to all roles at an AVP, DIR, VP, Head Of or SVP and above level):

Serve as a security contact for the business unit. Responsible for driving adoption and compliance with information security and privacy practices. Serve as a liaison with the information security team on security and privacy matters.

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.

#LI-Remote

Businessolver Denver, Colorado, USA Office

Denver, United States

Businessolver Greenwood Village, Colorado, USA Office

Greenwood Village, Colorado, United States

Similar Jobs

5 Minutes Ago
Remote or Hybrid
128K-189K Annually
Entry level
128K-189K Annually
Entry level
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Develop Python software and data systems that capture, validate, process, monitor, and deliver autonomous-vehicle telemetry from fleets to cloud and AI development pipelines. Own reliability initiatives, define architectures and operational metrics, debug distributed cloud and backend issues, improve observability and data quality, and apply AI/LLMs to incident triage and root-cause analysis. Collaborate across engineering and operations teams, lead design reviews, deliver tested production solutions, and mentor engineers.
Top Skills: APIsAutomated TestingBackend ServicesBigQueryC++CiCloud StorageContainer OrchestrationData PipelinesDistributed SystemsGCPKubernetesLlmsMetricsMonitoringPythonSQLTelemetry Pipelines
5 Minutes Ago
Remote or Hybrid
United States
69K-107K Annually
Expert/Leader
69K-107K Annually
Expert/Leader
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Provides on-site automotive technical support to GM dealerships and wholesale teams. Diagnoses vehicle and Techline issues, resolves escalated cases, supports repair and repurchase prevention, reviews dealership service readiness, trains personnel, troubleshoots IT and diagnostic tools, and reports product concerns to GM engineering and quality teams. The role manages territory relationships, supports arbitration and legal cases, and requires frequent travel, extensive automotive diagnostic experience, and strong customer and technical communication skills.
Top Skills: Buffalo ToolController Area Networks (Can)Gm Essential Service ToolsGm Global Connect Service ApplicationsGm LanGm Service Training CollegeInca ToolLan/WanMS OfficeNeoviPicoscopeTis/GdsV-Spy Intrepid Tools
5 Minutes Ago
Remote or Hybrid
United States
106K-141K Annually
Mid level
106K-141K Annually
Mid level
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Manages ACDelco sales and distribution across an assigned territory. Responsibilities include soliciting orders, growing aftermarket and fleet sales, developing customer relationships, directing sales representatives, executing marketing programs, maintaining inventories, supporting training, monitoring account compliance, analyzing market conditions, and contributing to forecasting and business planning. The role is field-based, requires frequent travel to dealerships, and involves attending trade events and managing customer and distribution activities.
Top Skills: ExcelMicrosoft OutlookMicrosoft PowerpointOem Parts Systems

What you need to know about the Colorado Tech Scene

With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.

Key Facts About Colorado Tech

  • Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
  • Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
  • Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
  • Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
  • Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account