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Insurance Support Specialist– Job Description

Employment Type: Full Time, Exempt
Level: Associate

Who we are:
At Herself Health, we're on a mission to help women get more life out of life, together. We are building a new model of primary care for women on Medicare to solve long-standing problems: rushed appointments, long wait times, and care that's generalized rather than specialized towards women's needs later in life such as post-menopausal care, bone density, weight management, and mental, social and emotional well-being.

Our clinics are located across the Twin Cities in Highland Park (St. Paul), Lyndale (S. Minneapolis), Crystal, Roseville (Rosedale), and Eagan. Our team of 100+ colleagues is on a mission to innovate the primary care landscape for women on Medicare. We're seeking like-minded individuals who share in this passion to join us!

About you:
As we grow, we're looking for people who thrive at the intersection of patient care and complex problem-solving. You're comfortable navigating Medicare and insurance systems, and you care about making that process easier for patients. You're organized, empathetic, and know how to communicate clearly across a wide range of people and situations.

About the Insurance Support Specialist Role:
We are seeking an Insurance Support Specialist to join our team at Herself Health. This role exists to make Medicare easier for our patients.

Medicare and Medicare Advantage plans come with real complexity: supplemental benefits patients don't know they have, plan assignments that need attention, cost-sharing questions that create confusion, and coverage gaps that can delay care. Insurance Support Specialists help patients navigate all of it. You'll guide patients through their coverage, connect them to benefits they're entitled to, and serve as a knowledgeable resource when insurance creates a barrier.

Some of your work happens directly with patients, and some happens behind the scenes in coordination with payers and our care teams.

This is a full-time, onsite role, Monday through Friday, 8:00 a.m. to 5:00 p.m.

Key Responsibilities:

• Educate and support patients through provider assignment and enrollment processes, including supporting end-to-end new patient onboarding
• Reconcile plan rosters against practice panels and flag discrepancies or new-to-plan patients for follow-up
• Educate patients on supplemental benefits available through their plan (dental, vision, OTC, transportation, fitness) and help them activate those benefits
• Serve as an insurance navigator between patients and their plans, with particular support for high-risk and dual-eligible populations
• Track and support LIS (Low Income Subsidy), mail-order pharmacy enrollment, and benefit utilization
• Identify and escalate payer assignment issues or systemic plan barriers to the appropriate internal team
• Help patients understand cost-sharing (copays, deductibles, out-of-pocket limits) and resolve billing or EOB confusion
• Assist patients with pharmacy benefit navigation, including Extra Help applications and manufacturer assistance programs

Must-have Qualifications and Skills:

• Strong customer service skills, with the ability to handle sensitive or complex situations with professionalism and empathy
• Excellent communication skills across patients, clinical staff, and insurance contacts
• Working knowledge of Medicare and Medicare Advantage plans, including supplemental benefits, dual eligibility, and Low Income Subsidy (LIS/Extra Help) programs
• Strong organizational skills and the ability to manage a varied caseload with competing priorities
• Comfort navigating ambiguous situations and identifying the right next step or escalation path

Nice-to-have Qualifications and Skills:

• Experience with plan enrollment verification or insurance record reconciliation
• Familiarity with pharmacy benefit programs, including mail-order and manufacturer assistance
• Experience working in a CRM, Salesforce preferred
• Experience with healthcare operations systems such as Athena Health
• Associate's or bachelor's degree, or equivalent experience

We support Equal Employment Opportunities (EEO). We are committed to an inclusive workplace. We do not discriminate on the basis of race, religion, color, national origin, gender identity or expression, age, marital status, veteran status, disability status, parental status, political affiliation, or any other status protected by federal, state, or local laws.