WPS, a health solutions company, is an independent, not-for-profit, local company based in Madison, Wisconsin. We’ve provided health insurance and benefit plan administration to millions of private and government members for almost 80 years. To us, it’s about more than delivering trusted and unparalleled expertise in the most demanding of businesses. It’s about caring for our members—and exploring innovative ways to enhance their lives.
Our mission: Relentlessly pursuing health solutions and value for those we serve.
We have four divisions:
Government Services: We are proud to administer Medicare and Medicaid benefits, plus military health benefits for millions of military members, veterans and their families around the globe.
Health Plan: We offer affordable health insurance plans to individuals, families and businesses, plus Medicare supplement insurance plans and administrative services.
Data Logistics: We can take care of printing, mailing, sorting, scanning, digitizing, shredding and more with the highest level of security for virtually any business.
New Ventures: We’re constantly evolving our business and seeking new ways to benefit our members by investing in start-ups, entering untapped markets and more.
We also actively partner with nonprofit organizations to help make lasting changes in our community, with a focus on mental health and wellbeing—especially for military members, veterans, women and children. Through sponsorships, donations, volunteerism and in-kind support, we strive to be a community member that lifts others up.
The Customer Care Center Rep serves as the primary point of contact for members, brokers, and providers regarding health plan benefits, eligibility, and claims.
They are responsible for resolving inquiries efficiently while documenting interactions and maintaining compliance with regulatory standards.
What you need
Candidates must have a high school diploma or GED and at least one year of customer service experience in a healthcare or insurance call center environment.
Proficiency in Microsoft Office and the ability to navigate multiple systems while maintaining high accuracy is required.
Role Snapshot
The Customer Care Center Rep plays a critical role delivering exceptional
service to our members, brokers, and providers. The role provides detailed
responses to health plan inquiries and resolves issues with compassion and
efficiency. The Customer Care Center Rep is the first point of contact for those
seeking assistance with benefits, eligibility, and claims questions. Success
is accomplished by navigating multiple systems to research and resolve inquiries
with a clear, accurate, and easy to understand response.
Additional Information
* Start Date: Tuesday January 12.
* Starting Base Salary: $20.50/hr.
* Training Location/Schedule: First 8 weeks, 8am-4:30pm Mon-Fri CT. Must be
present for all training.
* Scheduled Shift: Monday-Friday, from 8:30am-5:00pm CT. (once fully trained)
Work Location
We are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota,
Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas,
Virginia, Wisconsin
How do I know this opportunity is right for me? If you are looking to:
* Serve as the first point of contact for members, brokers, and medical
providers, answering inquiries regarding benefits, eligibility, claims,
billing, and healthcare services.
* Assist members in understanding their benefits, eligibility, claim status and
the resolution of billing issues.
* Respond to provider inquiries related to claims, authorizations, and
reimbursement status.
* Address and resolve service requests, complaints and issues efficiently,
ensuring high levels of customer satisfaction.
* Collaborate with internal teams to address complex inquiries and facilitate a
seamless experience.
* Review detailed information across multiple systems to accurately resolve
inquiries while delivering clear, professional, and thorough responses (both
written, and verbal), that are easy to understand by a diverse population.
* Accurately document all interactions in the system, ensuring thorough
record-keeping for follow-up actions and quality assurance purposes.
* Develop a thorough understanding of health plan products and services,
actively learning updates to policies, procedures, and regulatory
requirements.
* Ensure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing
information and service to members, providers or brokers.
* Other job-related responsibilities may be assigned as required.
Minimum Qualifications
* High School Diploma or GED or equivalent experience.
* One (1) or more years of customer service experience in a fast paced,
high-volume health insurance or healthcare call center environment.
* Strong verbal and written communication skills with the ability to
effectively explain complex information.
* Demonstrated problem-solving skills with the ability to handle difficult
situations with empathy and patience.
* Solid ability to multitask, prioritize, and manage time effectively in a
fast-paced environment.
* Ability to maintain a high level of accuracy and attention to detail.
* Proficiency in Microsoft Office Suite and website and/or portal navigation.
* Ability to adhere to a structured work schedule based around the central time
zone.
Preferred Qualifications
* Familiarity with customer service software such as Facets or NTT.
* Basic knowledge and understanding of medical terminology.
Remote Work Requirements
* High speed cable or fiber
* Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet
connection (can be checked at https://speedtest.net [https://speedtest.net]).
* Please review Remote Worker FAQs
[https://secure.wpsic.com/files/remote-work-faqs.pdf] for additional
information.
Benefits
* Remote work options available
* Performance bonus and/or merit increase opportunities
* 401(k) with a 100% match for the first 3% of your salary and a 50% match for
the next 2% of your salary (100% vested immediately)
* Competitive paid time off
* Health insurance, dental insurance, and telehealth services start DAY 1
* Professional and Leadership Development Programs
* Review additional benefits: (https://www.wpshealthsolutions.com/careers/
[https://www.wpshealthsolutions.com/careers/])
Who We Are
WPS, a health solutions company,
[https://www.wpshealthsolutions.com/about/index.shtml] is a leading
not-for-profit health insurer and federal government contractor headquartered in
Madison, Wisconsin. WPS offers health insurance plans for individuals, families,
seniors and group health plans for small to large businesses. We process claims
and provide customer support for beneficiaries of the Medicare program and
manage benefits for millions of active-duty and retired military personnel
across the U.S. and abroad. WPS has been making healthcare easier for the people
we serve for nearly 80 years [https://www.wpshealthsolutions.com/75/]. Proud to
be military and veteran ready.
Culture Drives Our Success
WPS’ culture is where the great work and innovations of our people are seen,
fueled and rewarded. We accomplish this by creating an open and empowering
employee experience. We recognize the benefits of employee engagement as an
investment in our workforce—both current and future—to effectively seek,
leverage, and include differing and unique perspectives that fuel agility and
innovation on high-performing teams. This results in people bringing their
authentic selves to work every day in an organization that successfully adapts
to business changes and new opportunities.
We are proud of the recognition we have received from local and national
organization regarding our culture and workplace: WPS Newsroom - Awards and
Recognition. [https://www.wpshealthsolutions.com/news/?c=awards]
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