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. Youll provide enrollment guidance verify health coverage and maintain case files to ensure members receive timely and accurate support. Youll bring strong customer service skills the ability to manage high call volumes and proficiency in Microsoft this role youll 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 Youll 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 Youll 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.

Required Experience:

IC