Support Services Specialist
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Job Description
Yuzu health-plan support specialist serving members and providers by phone. Resolving benefits, eligibility, claims, and authorization inquiries while supporting innovative healthcare delivery.
Responsibilities:
- Answer inbound calls from members and providers professionally and courteously
- Provide accurate information regarding benefits, eligibility, claims status, authorizations, and network participation
- Research and resolve complex inquiries by collaborating with internal departments
- Educate members and providers on plan policies, digital tools, and available resources
- Escalate issues as appropriate to ensure timely resolution
- Maintain confidentiality and adhere to HIPAA guidelines
- Meet or exceed performance metrics related to call quality, timeliness, and customer satisfaction
- Help evolve and strengthen the Support team as it scales
- Serve as the first point of contact for members and healthcare providers, delivering phone-based support
Requirements:
- Experience with innovative health insurance plan designs, including Reference-Based Pricing (RBP), cash payment models, and employer-sponsored Direct Primary Care
- Familiarity with HIPAA, CMS, or managed care guidelines
- Empathy and active listening
- Strong commitment to accuracy and attention to detail
- Ability to prioritize workload effectively in a fast-paced environment
- Strong communication skills
- Problem-solving and critical thinking
- Dependability and accountability
- Team-oriented mindset
- Bilingual skills, especially Spanish, are a plus
- Ability to work Monday–Friday, 9am–6pm EST
- Must answer whether sponsorship will be required to work in the United States
Benefits:
- Equity opportunities
- Health benefits
- 401K with Employer matching
- Career growth and development opportunities
- Remote capabilities
- High-trust team with radically high transparency and autonomy
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