Remote Care Operations Specialist

Leap; United States; Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Fully remote

Health, dental, and vision coverage

401(k) retirement plan

Competitive salary

Job summary

Leap is hiring a Care Operations Associate to be the operational backbone of member activation, ensuring every administrative step from enrollment to treatment is completed accurately and quickly. You will own back-office processes, linking providers, payers, pharmacy partners, and our clinical team, reporting to the Head of Member Ops.

& Strategy. This remote role demands a highly organized, process-minded operator who thrives on systematizing tasks and building scalable workflows in a

Qualifications

• 2+ years in a healthcare administrative or operations role supporting prior authorization or eligibility verification.
• Familiarity with payer portals, PA workflows, and follow-up/appeal processes.
• Proficiency with CRM or EHR systems and document management platforms, including fax.
• A proven track record managing high volumes of detailed work without dropping the ball.
• Comfort coordinating across provider offices, payers, pharmacy partners, and internal teams.
• Strong organizational and communication skills, and the ability to work independently during CST business hours in a fully remote setting.

Responsibilities

• Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins.
• Keep eligibility status accurate and current for every active member in our systems.
• Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end.
• Prepare and submit PA documentation, track approval status, and expedite stalled or denied authorizations before they delay care.
• Chase down unsigned documents and orders—following up proactively with provider offices so nothing stalls in limbo.
• Process incoming referrals, faxes, and clinical documents, routing each to the right place.
• Coordinate clinical staffing with staffing agencies to ensure providers are in place for each member's treatment.
• Coordinate medication shipping with pharmacy partners so the right therapy arrives at the right time.
• Answer inbound calls from providers, pharmacy partners, and occasionally members, triaging and routing each inquiry to the right team member.
• Document call details accurately and follow through on any action items.
• Represent Leap with professionalism and a service-oriented approach on every call.
• Collect, organize, and store member records and clinical documentation accurately and on time.
• Ensure all files meet internal standards and HIPAA compliance requirements.
• Design, document, and continuously improve the workflows behind all of the above—turning manual, ad hoc tasks into repeatable systems as we scale.

Skills

Healthcare admin

Prior authorization

Eligibility verification

CRM/EHR proficiency

Tools

CRM software

EHR systems

Document management

Job description

Leap is hiring a Care Operations Associate to be the operational backbone of member activation, ensuring every administrative step from enrollment to treatment is completed accurately and quickly. You will own back-office processes, linking providers, payers, pharmacy partners, and our clinical team, reporting to the Head of Member Ops.

& Strategy. This remote role demands a highly organized, process-minded operator who thrives on systematizing tasks and building scalable workflows in a