Operations Specialist
hace 5 días
We are seeking an Operations Specialist to support U.S.-based education benefits programs. This role primarily focuses on claims-style processing and documentation review, including tuition reimbursement and plan enrollment. The position also involves light, intermittent participant outreach during program launch periods. This is not a sales or call‑center role. Success in this position requires a high level of accuracy, strong documentation discipline, and strict adherence to established SOPs. Strong support system Training materials for upskilling are provided Paid holiday leaves (depending on the holidays that the client observes) Paid sick leave (sick leave convertible to cash if perfect attendance) Paid planned leaves Key Responsibilities Benefits Processing (Primary) Review and verify participant documentation (tuition invoices, proof of payment, enrollment records, grades). Process reimbursement requests in accordance with established eligibility criteria. Enter reimbursements correctly in U.S. systems, distinguishing taxable vs. non‑taxable. Maintain clean case notes and audit trails. Flag exceptions and escalate according to workflow documentation. Participant Outreach & Enrollment (Secondary) Make light outbound calls to eligible participants who haven’t enrolled. Handle inbound questions about enrollment steps and benefit basics. Guide participants through enrollment and documentation using scripts. Document all interactions in the case management system. Escalate complex or policy questions to U.S. staff. Ad‑Hoc Tasks Support process improvements or documentation updates as needed. Assist with special projects or reporting assigned by the U.S. operations staff. Participate in training or cross‑functional activities when required. Handle other operational tasks related to benefits programs as assigned. Note: Call volume is light but bursty around program launches. Requirements & Qualifications 2+ years of experience in U.S. healthcare claims processing, HR benefits administration, or financial services operations. Prior experience supporting U.S. clients preferred. Comfortable with rule‑based adjudication and documentation verification. Strong attention to detail and commitment to accuracy. Clear, professional spoken and written English communication; confident on the phone. Ability to follow SOPs, scripts, and escalation workflows without independent policy interpretation. Proficient with case management systems, spreadsheets, and basic office software. Adaptable and capable of handling ad‑hoc tasks or special projects as assigned. Two professional references and a valid criminal background check issued within the last 60 days are required for all successful applicants. Completion of intake paperwork, including submission of a valid tax identification number (e.g., Social Security Number, Social Insurance Number, or the country’s equivalent), is required before onboarding. Operating Assumptions SOPs, scripts, and escalation paths are provided Agent follows rules; no independent policy interpretation QA is lightweight and sample‑based No automatic expansion of hours or headcount without explicit approval Working Hours Part-Time (20 hours per week) Monday through Friday, 8:00 a.m. to 12:00 p.m. or 1:00 p.m. to 5:00 p.m. Eastern Time Pay $350 + $30 Allowance per month #J-18808-Ljbffr
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