Healthcare Support Specialist

Job Overview-

As a Healthcare Support Specialist, you will play a vital role in supporting Medicaid-eligible recipients and their families through the HIPP / Premium Assistance program. You'll provide enrollment guidance, verify health coverage, and maintain case files to ensure members receive timely and accurate support. You'll bring strong customer service skills, the ability to manage high call volumes, and proficiency in Microsoft Excel. In this role, you'll make a meaningful impact by helping families access essential healthcare benefits while developing valuable skills in case management and program administration.

Work Schedule :

Monday - Friday, 8 : 00 AM to 5 : 00 PM EST

Work Location :

Hybrid contract, mostly remote, with onsite training

What We Offer :

Paid sick leave based on state regulations after 90 days of employment

Medical, dental, and vision coverage after a waiting period (60% paid by Fortuna)

Free TeleMedicine and Mental Health support for all employees and their families

Additional voluntary benefits : Group Life Insurance, Accidental Insurance, Critical Care, Short-Term Disability

What You'll Do :

Provide enrollment assistance and guidance to Medicaid-eligible recipients and their families regarding the HIPP / Premium Assistance program via phone or correspondence

Verify, document, and investigate existing health coverage (employer plans, COBRA, etc.) for Medicaid recipients and dependents

Identify members who may qualify for HIPP / Premium Assistance

Obtain and verify required eligibility documents (insurance policies, employment verification, premium invoices, etc.)

Maintain active case files during open enrollment cycles, premium review, and payment processing

Process, review, and follow up on premium payments / reimbursements, ensuring accuracy and timeliness

Perform ongoing case maintenance and audits, updating records for status changes, renewals, terminations, or escalations

Complete periodic reporting (case metrics, enrollment trends, audit reports) for state or internal stakeholders

Respond to high volumes of inbound and outbound calls and inquiries about eligibility, coverage, program rules, and case status

Conduct advanced document review, legal research, or case escalation for complex cases

Prioritize case events, manage deadlines, and escalate issues to supervisors or subject matter experts when appropriate

What You'll Bring :

Substantial customer service experience with the ability to handle high call volumes

Strong multitasking skills and the ability to thrive in a fast-paced environment

Basic knowledge of health insurance and related terminology

Proficiency in Microsoft Excel for data tracking, reporting, and case management tasks

Attention to detail and accuracy in documentation and payment processing

Strong communication skills (written and verbal) for client interactions and reporting

Problem-solving ability and sound judgment when escalating complex cases

Organizational skills to manage multiple case files and deadlines simultaneously

About Fortuna

Fortuna operates as a staffing agency engaged in sourcing, screening, and presenting potential candidates for employment opportunities on behalf of our clients.

Founded in 2012 by practicing professionals with more than 50 combined years of experience, Fortuna is headquartered in McClellan, California, with offices in Los Angeles and New York, and satellite offices in the Philippines and Israel. Fortuna is an active member of multiple California service agreements, including the CMAS, ITMSA (Tier 2), and CalPERS SpringFed Pool, as well as multiple municipalities and large corporation vendor pools.

Job Posted by ApplicantPro