Support Specialist

Healthfirst

. Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests .

Posted 11/5/2026full-timeRemote • United StatesMid-LevelSenior💰 $40,200 - $54,570 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates proficiency in managing member communications and authorizations while ensuring compliance with service request requirements. Capable of handling multiple priorities in a fast-paced environment, with strong documentation and communication skills.

Highest-signal resume keywords

Customer Service ExperienceEffective Communication SkillsTrucare ProficiencyKnowledge Of Medical TerminologyExperience In Managed Care

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Documentation SkillsAuthorization ManagementIntake ReviewAssessment CompletionCall Handling

Soft Skills

Multitasking AbilityAttention To DetailProblem-Solving Skills

Tools & Technologies

SalesforceHHAXchangeDocuSign EpacesSharepointMicrosoft Office Suite

Certifications & Qualifications

High School DiplomaGED EquivalentAssociate Degree/Certification In Related Field

Industry Keywords

Durable Medical EquipmentManaged CareCall Center EnvironmentConsumer Directed Personal AssistantClinical Escalations

About the role

Key responsibilities & impact

Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests
Review intake documents for pre-approved services and escalate discrepancies as needed
Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify issues or risk factors requiring clinical escalations to a CM/PCM
Initiate and finalize authorization in Trucare for preapproved services and DMEs; update and discontinue authorizations when applicable
Handle and accurately document calls to and from members regarding benefit questions/issues, appointments, assessment inquiries, service issues and grievances
Handle and accurately document calls to and from providers regarding authorization initiation/updates, referrals, visits, tests and faxed care plans
Provide education to members and providers regarding requirements for approval of service requests
Manage a large caseload while communicating member issues or needs and monitoring screening of members to improve quality and cost outcomes
Communicate with Inter/Intra-departments regarding reconciling onboarding issues
Handle member mailings and fax clinical requests and approved authorized service plans
Perform additional duties as assigned

Requirements

What you’ll need

High School diploma or GED equivalent
Experience in a customer service environment
Experience working in a fast-paced environment that requires handling multiple priorities simultaneously
Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills
Preferred: Associate Degree/Certification in a related field
Preferred: English proficient bilingual who also speaks Spanish or Mandarin/Cantonese
Preferred: Knowledge of medical terminology
Preferred: Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint
Preferred: Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
Preferred: Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams
Preferred: Demonstrated ability to document calls into a computer system

Benefits

Comp & perks

Medical, dental and vision coverage
Incentive and recognition programs
Life insurance
401k contributions (all benefits are subject to eligibility requirements)
Competitive compensation and benefits package