Managed Care Specialist

Bridging the gap between members and their healthcare benefits, the full-time Healthcare Operations Specialist will manage benefit coverage inquiries, claims, and authorizations while fostering member relationships to enhance retention. Key responsibilities Handle benefit coverage questions, claims, and authorizations Manage member relationships to support retention Clearly explain insurance concepts to members and providers Required qualifications Solid understanding of claims, liabilities, and insurance coverage Ability to remain calm under pressure and respond thoughtfully Strong communication skills, both verbal and written Basic comfort with business systems and databases