Partner Services Operations Specialist - Remote

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What We Offer You:

• A culture that values employees and celebrates, empowers, and inspires a diverse workforce
• Outstanding and affordable benefits package
• 3.5 weeks of PTO and 11 paid holidays
• 401(k) with up to 6% match; fully vested from day 1
• Remote opportunities with company-provided equipment
• Team-oriented, collaborative group of peers
• Career advancement opportunities
• Tuition Reimbursement
• Employee Assistance Program
• Inclusion Council and Employee Resource Groups
• Recharge Days and Volunteer Time Off
• This is a remote position.

Life Takes You Places! Are you ready to join us?

Pay Transparency: Anticipated pay for new hires is between $56,000 and $60,00. The full pay range for the Partner Services Ops Specialist is $56,000 to $78,900. Pay is based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications, and company tenure & equity. In addition to base compensation, this role is eligible for an annual incentive plan based on company performance and individual performance.

Before You Apply: Please review these qualifications carefully before applying. This role is best suited for candidates with experience supporting insurance, benefits administration, or operational service functions. Candidates without experience researching and resolving benefit, enrollment, billing, or service-related issues may be less competitive for this role.

• 1+ year of experience in insurance, benefits administration, customer service, operations, or partner support
• Experience researching and resolving operational or service-related inquiries
• Ability to interpret benefit, eligibility, enrollment, billing, or claims information
• Proficiency with Microsoft Office 365 (Excel, Word, Outlook)

Partner Services Operations Specialist Overview

The Partner Services Operations Specialist provides professional operational support for Partner service operations across ancillary product lines through research, analysis, issue resolution, and cross-functional coordination. This role is responsible for researching and resolving Salesforce inquiries, access-to-care issues, subrogation requests, benefit summary requests, and other operational needs. The position supports operational benefit work and activities, data coordination, transmittal updates, benefit grid maintenance, reporting, documentation, issue tracking, and cross-functional follow-through to ensure accurate, timely, and audit-ready Partner service support.

Essential Duties:

• Evaluate and coordinate resolution of Partner service inquiries received through Salesforce, shared support mailboxes, and other service channels; analyze request details, interpret available information, determine appropriate next steps within established procedures, document actions taken, provide timely updates, and ensure cases are tracked through resolution in accordance with departmental procedures and service level expectations
• Analyze, research and coordinate resolution of benefit, eligibility, enrollment, reinstatement, retroactive cancellation, service access, subrogation, subpoena, benefit summary, and other ancillary product-related inquiries by reviewing multiple factors, interpreting available information, and partnering with internal departments, business partners, vendors, and legal resources as appropriate
• Apply established benefit operations guidelines to support new groups, benefit changes, plan updates, coverage code changes, transmittal processing, benefit grid maintenance, and validation of benefit information maintained internally or shared with operational partners; identify discrepancies, assess operational impact, and recommend next steps when appropriate
• Analyze, validate, coordinate, and monitor operational reports, tracking files, mapping documents, rollover items, delinquency or coverage-related follow-ups, invoice support items, and other assigned reporting activities; identify variances, resolve routine issues within defined authority, and escalate exceptions when needed
• Identify recurring service issues, operational trends, documentation gaps, and process concerns; evaluate potential causes, present findings to leadership, and recommend corrective actions, process improvements, quality control steps, and consistency improvements across partner service workflows
• Represent assigned workstreams in partner and internal meetings as needed; provide informed updates and recommendations on assigned service items, clarify operational requirements, assess implementation or service impacts, and coordinate next steps with Account Management, underwriting, enrollment, billing, claims, service teams, vendors, and other business partners
• Maintain complete, accurate, and audit-ready documentation within Salesforce, applicable reports, shared tracking tools, and departmental resources; evaluate documentation completeness and consistency to support transparency, continuity, and compliance with internal documentation standards
• Contribute to the development, review, and maintenance of standard operating procedures, training materials, resource lists, implementation guidance, cross-training tools, and other departmental reference materials by identifying needed updates and recommending content improvements
• Facilitate knowledge sharing and coordinated coverage for assigned workflows to promote team continuity, reduce single-person dependencies, and ensure consistent handling of partner service work
• Performs other related duties and responsibilities as assigned

Required Knowledge, Skills and Abilities:

• Working knowledge of ancillary insurance operations, including benefit administration, claims, enrollment, billing, partner support, and service issue handling
• Ability to research complex operational questions, analyze available information, and determine appropriate next steps for resolution
• Ability to interpret benefit, eligibility, enrollment, billing, claims, and service-related information accurately
• Ability to document case activity, research findings, decisions, and follow-up actions clearly and completely
• Ability to identify recurring trends, service issues, documentation gaps, and process concerns
• Ability to coordinate issue resolution across internal departments, business partners, vendors, and other external contacts
• Strong written and verbal communication skills, including the ability to provide clear status updates and explain operational information effectively
• Strong attention to detail, organization, follow-through, and ability to manage multiple priorities in a fast-paced environment
• Customer service mindset with the ability to support partners, members, providers, vendors, and internal stakeholders professionally and responsively
• Proficiency with Microsoft Office 365 required; Salesforce, Bastion, reporting tools, and/or related insurance operational systems preferred

Required Education and Experience:

• Bachelor’s Degree or equivalent related experience
• 1 year of relevant ancillary insurance, benefits administration, customer service, operations, or partner support experience
• Proficiency in Microsoft Office 365, including Excel, Word, Outlook, and PowerPoint, required

Preferred Education and Experience:

• Experience with Salesforce case management, operational reporting, and shared tracking tools preferred
• Experience supporting partner service workflows and coordinating cross-functional issue resolution preferred

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