Customer Care Center Rep

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 July 14.
• 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).
• Please review Remote Worker FAQs 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/)

Who We Are

WPS, a health solutions company, 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. 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.

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