medical back office case worker.

In this role, you won't just be entering data-you'll be the operational backbone of our member services, ensuring accuracy, eligibility, and seamless case management for individuals enrolled in Medicare, Medicaid, and Managed Care programs. If you thrive in a structured office environment, love solving puzzles, and take pride in precision, we want to hear from you!

Responsibilities:
Manage Case Files: Review, update, and maintain member records accurately and efficiently.
Process Request: Handle healthcare enrollment, eligibility verification, and member updates.
Solve Discrepancies: Research and resolve account or enrollment issues to keep cases moving smoothly.
Track to Completion: Monitor cases from start to finish, ensuring strict turnaround times are consistently met.
Program Support: Support administrative workflows related to Medicare, Medicaid, Medicare Advantage (MA), Dual Special Needs Plans (D-SNP), and Managed Care.
Ensure Compliance: Verify documentation to meet program regulations, quality guidelines, and internal standards.
Teamwork & Quality: Collaborate across departments to resolve inquiries, participate in quality audits, and drive continuous improvement.

Working hours: 10:00 AM - 6:30 PM

Skills:
Prior experience in healthcare administration, health insurance operations, member services, or back-office case processing.
Familiarity with Medicare, Medicaid, Medicare Advantage (MA), D-SNP, and Managed Care programs.
Hands-on experience with healthcare databases, claims, or enrollment systems.
Familiarity with HIPAA compliance and healthcare regulations.

Education:
High School

Experience:
1-4 years

Qualifications:
Education: High School Diploma or GED required (Associate???s degree preferred).
Industry Foundations: Basic knowledge of the healthcare and health insurance industry, including standard terminology and member administration processes.
Tech-Savvy: Strong typing and data entry skills with proficiency in Microsoft Office (especially Excel and Outlook).
Core Skills: Exceptional attention to detail, strong problem-solving abilities, and excellent written/verbal communication skills.
Pace & Focus: Ability to multi-task, prioritize effectively, and thrive in a fast-paced, deadline-driven office environment.


100% Onsite: Full-time, office-based environment working closely alongside a collaborative team.
Dynamic Workday: Involves extended periods of computer work, high-volume data entry, and meeting key productivity targets.
Ready to Apply? If you are ready to apply your administrative talents to a meaningful career in healthcare, apply today and take the next step in your career!

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).