Processing Specialist I - Special Processing

About Businessolver

Since 1998, Businessolver has delivered market-changing benefits technology and services supported by an intrinsic responsiveness to client needs. 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.

The Role

The Processing Specialist I - Special Processing provides advanced HR support focusing on benefit processing, compliance, and member services. You will be responsible for managing complex cases including condolence management, QMCSO compliance, benefit appeals, POA documentation, and Medicare L564 requests. Ensure accuracy, compliance with HIPAA, IRS, and CMS regulations, and maintain workflow continuity while supporting process improvements and mentoring junior staff.

Key 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.

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.