Health Services Specialist

Are you detail-oriented, organized, and passionate about helping people navigate healthcare? Do you enjoy working with healthcare providers, solving problems, and making sure patients receive timely access to services?

Comagine Health is looking for a Health Services Specialist to join our team!

Remote – Washington State

This position is designated as remote within Washington State. Candidates must reside in Washington.

In this role, you'll support healthcare providers, clinical teams, and members by coordinating service requests, managing healthcare documentation, and helping ensure medical management processes run smoothly.

Comagine Health is a national nonprofit healthcare consulting organization dedicated to improving healthcare quality, access, and outcomes.

We collaborate with healthcare providers, health plans, government agencies, and community partners to help create a more effective, equitable, and patient-centered healthcare system.

At Comagine Health, your work contributes to something meaningful—helping improve healthcare for the people and communities we serve.

As a Health Services Specialist, you'll play an important role in supporting our healthcare operations and ensuring providers and members receive responsive, accurate, and professional service.

Your day-to-day responsibilities will include:

• Support healthcare providers: Assist providers with submitting medical service requests, using online provider portals, understanding documentation requirements, and navigating medical management processes.

• Process healthcare requests: Receive and coordinate referrals, prior authorization requests, utilization review cases, and case management requests through electronic portals, phone, fax, and other communication channels.

• Review documentation for accuracy: Verify that service requests are complete and accurate, identify missing medical information, and follow up with providers or other appropriate contacts.

• Deliver excellent customer service: Answer inbound calls, respond to provider and member questions, document interactions, and help resolve routine inquiries and concerns.

• Maintain accurate healthcare records: Enter information into electronic healthcare management systems, upload medical documentation, organize case files, and maintain detailed records.

• Support utilization management: Work alongside clinical reviewers and physicians to process review outcomes, verify determination information, and prepare accurate notification letters.

• Coordinate care management services: Help schedule assessments, coordinate transportation or accommodation requests, obtain necessary consents, and assist with non-clinical care coordination.

• Collaborate with clinical teams: Communicate with nurses, physicians, case managers, and other healthcare professionals to support timely processing of requests.

Additional responsibilities may include:

• Completing scripted clinical review screenings and referring cases requiring clinical judgment to qualified clinical staff.

• Communicating service determinations to providers following physician review, as directed.

• Supporting quality assurance reviews, training activities, and process improvements.

• Assisting with case closure and maintaining compliance with program requirements.

Required Qualifications

• High school diploma or GED.

• At least 2 years of related work or customer service experience.

• At least 1 year of experience working in a healthcare setting.

• Strong written and verbal communication skills.

• Excellent attention to detail, organization, and follow-through.

• Ability to manage multiple priorities while maintaining accuracy.

• Strong customer service skills and a…