Operations Support Specialist - Remote Eligible

Operations Support Specialist

Ready to create a healthier world? Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future.

Responsibilities

Ready to be the detail-oriented backbone of claims operations? We're seeking a meticulous professional who can handle critical operational tasks that keep our claims processes running smoothly. As our Operations Support Specialist, you'll manage appeals logging, overpayment recovery, and provide essential backup support across multiple locations while ensuring accuracy and efficiency in fast-paced environments.

What makes this role different:

• Process critical impact: Your attention to detail in logging appeals and managing overpayments directly affects claim resolution timelines and accuracy.
• Multi-location support: Provide flexible backup assistance across different operational areas when business needs require.
• Systems expertise: Work with specialized claims systems like Qiclink and Eldorado while building valuable healthcare operations experience.
• Customer service focus: Practice excellent service principles that foster positive corporate relations and member satisfaction.

What you'll actually do:

• Monitor and manage appeals: Review emails, system mailboxes, and scan folders in claims systems to accurately log appeals as they arrive, ensuring proper documentation and tracking.
• Handle overpayment recovery: Make professional calls to recover overpayments while maintaining positive relationships and clear communication with all parties involved.
• Provide operational backup: Support other locations and departments when needed, demonstrating flexibility and cross-functional capabilities.
• Complete specialized tasks: Handle various assignments from management including document retrieval, data entry, and administrative support that keeps operations running efficiently.
• Maintain quality standards: Ensure extreme accuracy in all tasks while meeting deadlines and supporting team objectives in a fast-paced environment.

Qualifications

What you bring to our mission:

• High school graduation or equivalent (GED)
• Knowledge of medical terminology, ICD-10, CPT & HCPCS coding
• Experience working in medical insurance companies
• Experience with Qiclink and/or Eldorado Claims systems preferred

• Proficiency in Word, Excel, and Outlook
• Understanding of medical claims processing and workflow
• Ability to learn and navigate specialized healthcare software systems

• Demonstrate ability to work independently with excellent judgment
• Ability to organize, prioritize, and multitask in a fast-paced, deadline-driven environment
• Good time management skills with a highly organized, detail-oriented approach and extreme accuracy
• Foster good corporate relations by practicing excellent customer service principles including a positive attitude and helpful approach
• Strong communication skills for professional phone interactions and written documentation

Why you'll love it here

We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work.

• Your wellbeing comes first: Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!)
• Mental health support and wellness programs designed by experts who get it
• Flexible work arrangements that fit your life, not the other way around

• Financial security that makes sense: Retirement planning support to help you build real wealth for the future
• Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
• Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage

• Growth without limits: Professional development opportunities and clear career progression paths
• Mentorship from industry leaders who want to see you succeed
• Learning budget to invest in skills that matter to your future

• A culture that energizes: Inclusive community where every voice matters and diverse perspectives drive innovation
• One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
• We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
• Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable

• The practical stuff: Competitive base salary that rewards your success
• Unlimited PTO policy because rest and recharge time is non-negotiable
• Benefits effective day one—because you shouldn't have to wait to be taken care of

Ready to create a healthier world? We are ready for you.

No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you.

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $17.00 to $20.00 per hour. Note that compensation may vary based on location, skills, and experience.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

Beware of hiring scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.