Special Processing Specialist II (Remote)

Socket.dev; United States; Remote; USD 22,000 - 29,000; Full time

Job summary

Businessolver is seeking a Special Processing Specialist II to provide advanced HR support with a focus on benefits processing, compliance, and member services. You will manage complex cases including QMCSO, L564 forms, POA requests, and eligibility updates, while ensuring HIPAA and CMS compliance.

The role emphasizes accurate data handling, informed client communication, and collaboration across teams. Strong HRIS and Microsoft Office proficiency, plus 2–3 years in HR operations, are preferred.

Qualifications

• 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.

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

HR operations

HIPAA compliance

HRIS

Microsoft Office

Communication

Education

Bachelor's degree in HR / Business

Tools

HRIS software

Microsoft Office

Job description

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 (pay to be determined by the applicant’s education, experience, knowledge, skills, abilities, balanced against internal equity and competitive market based geographic ranges).

Other Compensation: