Healthcare Operations Specialist

1 week ago

Islamabad, Islamabad, Pakistan beBeeInsurance Full time 5,000,000 - 7,500,000

As a detail-oriented and organized professional, you will play a crucial role in supporting our Medicare and Under-65 Health Insurance operations.

About the Role

This position requires proficiency in using AgencyBloc, MyHealthPlan, and other insurance portals to manage client data, plan comparisons, portal submissions, policy follow-ups, and customer service support.

Key ResponsibilitiesMedicare (65 and above)

You will work with various software and portals including AgencyBloc, MyHealthPlan (MHP), Carrier portals (Aetna, UHC, Wellcare, Regence, DeltaDental) to ensure seamless client experiences.

Pre-Policy Tasks:

  • Conduct thorough Medicare eligibility checks prior to policy submission.
  • Collect essential client data including prescriptions, doctors, and Scope of Appointment via email.
  • Enter prescription details into MyHealthPlan to evaluate cost and coverage, and prepare comprehensive plan comparisons.
  • Identify in-network doctors to minimize client costs.

Post-Policy Tasks:

  • Record policies in the Book of Business (BOB) and AgencyBloc (AMS).
  • Track policy status actively ensuring timely updates.
  • Coordinate with carriers to resolve delays or issues and communicate effectively with clients.
  • Email & Client Management:
    • Prepare multiple policy comparisons for client meetings retaining key plan details based on prescriptions and doctors.
    • Schedule client meetings efficiently using Calendly.
    • Handle customer service calls and assist clients in locating in-network providers.
    • Submit required documents to carriers for pending policies.
  • Assist with data cleanup and special projects as needed.
Medical (Below 65)

Software: Washington Health Plan Finder (WAHPF)

Update AMS accounts with current client information.

Monitor client plan selections and proactively follow up to ensure deadlines are met.

Skills & Qualifications

A bachelor's degree or equivalent experience in healthcare administration, insurance, or a related field is preferred. Experience with Medicare and health insurance processes is also highly valued.

The ideal candidate should possess strong organizational skills, attention to detail, excellent communication skills, and the ability to manage multiple tasks and deadlines effectively.

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