We are seeking a detail-oriented, proactive, and results-driven Healthcare & Workers’ Compensation Operations Specialist to join our growing team. In this role, you will manage high-volume case queues, serving as the critical liaison between pharmacies, payers, and patients to coordinate pending approved medications and streamline billing workflows. Utilizing Microsoft Dynamics 365, you will prioritize time-sensitive tasks, maintain rigorous HIPAA compliance, and resolve operational bottlenecks. The ideal candidate possesses exceptional follow-through abilities, sound independent judgment, and a strong background in customer support within a fast-paced BPO or US healthcare setting.

Responsibilities:

• Handle call back cases to coordinate with pharmacy to process pending approved medications.n.

• EIdentify and prioritize cases that need immediate action and/or escalation.

• Assist pharmacies with updating payers’ billing information..

• Document and update records in Microsoft Dynamics 365.

• Consistently meet required metrics while maintaining quality standards.

• Adhere to all company policies and procedures, and local, state and federal laws and regulations.

• Other duties as assigned.

• English level: C1 or above

• Experience in US Healthcare and Workers’ Compensation is an advantage.

• Knowledge of HIPAA principles and standards is an advantage.

• Exposure to Microsoft Dynamics 365 is an advantage

• Must have excellent organizational, communication and customer service skills.

• Excellent follow-through abilities and ability to coordinate several items simultaneously..

• Exercise considerable discretion, maintain confidentiality and practice independent judgment.

• Minimum 2 years of customer service experience in any field required.

• Work as a team player in conjunction with all areas of the organization

• Demonstrates initiative to proactively solve issues with minimal supervision