Substantiation Analyst I - Fully Remote (Customer Service)

Who We Are:

Nonstop Administration and Insurance Services, Inc. is a fast-growing health insurance organization with a firm belief that everyone should have access to high-quality, affordable healthcare. To achieve this goal, we offer an employer-sponsored group health insurance solution called Nonstop Health ®

What Nonstop is Looking For:

 We are looking for a highly organized, customer-focused, and detail-oriented analyst to join our substantiation team. At Nonstop, we are committed to investing in your growth and providing opportunities for career advancement. We seek a professional with experience in health insurance and benefits to deliver exceptional support to our members. The ideal candidate will confidently address complex inquiries related to eligibility, benefits, coverage, billing, and other related matters. Are you a highly skilled, detail-oriented professional with a passion for delivering exceptional customer service? Nonstop is seeking a professional to join our substantiation team—the perfect role for someone with expertise in health insurance and benefits who thrives on solving complex challenges.

At Nonstop, we invest in your growth and provide clear pathways for career advancement. As a key member of our team, you’ll confidently handle inquiries related to eligibility, benefits, coverage, billing, and more—making a meaningful impact on the members we serve. If you’re ready to take the next step in your career, we want to hear from you!

Primary Responsibilities

• Resolves assigned tickets in a timely manner with expert customer service using SWIPE within NSE
• Maintains initial and consistent communication with members, using appropriate personalized responses
• Maintain detailed notes and loop in leadership as needed
• Create an organized and detailed spreadsheet to track tickets at all stages, until resolved
• Comfortable working in an evolving, high-paced, high-volume remote environment
• Excellent understanding of credit card transactions in the healthcare
• Expert understanding of healthcare and benefits in and out of network (transaction eligibility/provider & facility) 
• Demonstrates strong customer service while helping members navigate their medical benefit offerings through Nonstop
• Experience working with and explaining invoices
• Ability to collect accurate and precise information for collection purposes (as/if needed)
• Guides members through insurance forms such as Summary of Benefits and Explanation of Benefits
• Occasionally work with medical carriers and service provider billing and claims departments to help resolve confidential member issues
• Provides clarification to members regarding Nonstop programs including, but not limited to, DME, AltCare Plus, Infertility, and the claims process. 
• De-escalates situations involving dissatisfied members by offering patient, empathetic, and skilled support. 
• Maintains customer satisfaction at the core of every decision and task
• Builds sustainable relationships and engages members by going the extra mile
• Adheres to Nonstop guidelines, policies, and processes, as well as strict observance of HIPAA regulations and client confidentiality agreements
• Commits to ongoing professional development 

Required Skills, Experience, and Education:

• Dedicated workspace free from distractions 
• Ability to adapt to changing requirements with a positive attitude
• Confident critical thinker with intuitive and creative problem-solving abilities
• Must be able to learn CRM systems 
• High Speed reliable internet 
• Excellent organizational skills, proficient multitasker, and attention to detail
• Must be an expert in customer service and an organized self-starter 
• Ability to commit to deadlines
• Ability to confidently request assistance and take direction as needed
• Willingness to work a flexible schedule (if requested)
• Ability to communicate with staff, management, and clients effectively and professionally
• Strong phone and writing skills (required)
• High school diploma or GED equivalent (required)
• Proficient with Google Suite products (Sheets, Docs, etc.) or equivalents
• Familiarity with medical insurance and medical benefits 

Perks and Compensation:

• Full-time / Non-exempt / Hourly Position 
• Hourly Rate $28.85 
• Internet Reimbursement
• Fully Remote Position (Virtual / Work From Home)
• Monday - Friday schedule with No Weekends!!
• 401(k) plan participation with employer-matched contributions
• Full medical, dental, and vision benefits with 100% employer-paid premiums after the introductory period is met
• Voluntary Benefits offered for employees and dependents

Physical Requirements: 

• Prolonged periods sitting at a desk and working on a computer per day
• Repetitive use of fingers, hands, elbows, and arms including typing, reaching, grasping, and writing
• Ability to lift, carry, push, pull, and carry 5-30 pounds occasionally
• Hearing and speaking ability sufficient to carry on a conversation with another individual (or groups of individuals) in person and over the telephone.
• Visual ability is sufficient to read and produce printed material and information displayed on a computer screen.

Nonstop provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.