Complaint Intake Specialist - Federal Health Benefits
Full-TimePosted on 10/1/2026
$24.20/hr
Junior
Washington, DC, USA
In Person
No H1B Sponsorship
About the job
Requirements
A high school diploma or equivalent is required.
At least one year of data entry, case processing, claims, customer service, or administrative support experience is required.
Comfort working in a case management or records system and accurate typing at volume are required.
Clear written and telephone communication is required for speaking with medical billing offices and health plan representatives.
Ability to be reliably on-site in downtown Washington, DC is required.
U.S. person status and the ability to obtain and maintain a favorable federal suitability determination (Minimum Background Investigation / Trusted Workforce 2.0 moderate) are required. No work may begin before the determination is favorable.
Responsibilities
Review new daily complaints, identify the allegations, and route them correctly.
Screen complaints against defined jurisdiction categories and flag those requiring notification to the Agency within two business days.
Enter and maintain complaint records accurately in the Government's Technical Assistance Inquiry System (TAIS).
Contact complainants to obtain information missing from a filing and follow up until the required information is received.
Contact health plans by telephone and pre-approved email templates, logging every contact and response.
Keep complainants informed about unresolved cases and escalate cases that are not progressing before they age.
Correct data errors in existing records and support recurring reporting to the Agency.
Desired Qualifications
Health plan, medical billing, or federal case-processing experience is a strong plus.
Total hourly compensation: $24.20 per hour — about $50,300 a year at 2,080 paid hours
Schedule: Full-time, Monday through Friday, scheduled within a 7:00 a.m. to 7:00 p.m.
The work
Providers and their billing offices file complaints against health plans under the No Surprises Act, the federal law protecting patients from surprise medical bills. The Agency has 60 days to respond to each one.
Review each day's new complaints, identify what is being alleged, and route them correctly.
Screen complaints against defined jurisdiction categories and flag the ones requiring notification to the Agency within two business days.
Enter and maintain complaint records accurately in the Government's Technical Assistance Inquiry System (TAIS).
Contact complainants for information missing from a filing and follow up until you have what is needed.
Contact health plans by telephone and pre-approved e-mail templates, logging every contact and response.
Keep complainants informed on unresolved cases and escalate a case that is not moving before it ages.
Correct data errors in existing records and support recurring reporting to the Agency.
What you need
High school diploma or equivalent.
One year or more of data entry, case processing, claims, customer service, or administrative support experience. Health plan, medical billing, or federal case-processing experience is a strong plus.
Comfort working in a case management or records system and typing accurately at volume.
Clear written and telephone communication. You will be speaking with medical billing offices and health plan representatives.
Ability to be reliably on-site in downtown Washington, DC.
U.S. person status, and the ability to obtain and maintain a favorable federal suitability determination (Minimum Background Investigation / Trusted Workforce 2.0 moderate). No work may begin before that determination is favorable.