Health Insurance Care Specialist - Remote

WPS Health Solutions; Houston (TX); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

401(k) with match

Health and dental insurance

Paid time off

Professional development

Day 1 benefits start

Job summary

WPS Health Solutions is seeking a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will provide detailed responses on benefits, eligibility, and claims, navigating multiple systems to researching and resolving inquiries with clarity and empathy.

The role requires strong communication, accuracy, and the ability to document interactions in the system for QA.

Qualifications

• High School Diploma or GED required.
• 1+ year in a fast-paced health insurance or healthcare call center.
• Strong verbal and written communication.
• Ability to research and resolve inquiries across multiple systems.
• Maintain accuracy and attention to detail.
• Work schedule aligned to Central Time.

Responsibilities

• Serve as first contact for members, brokers, and providers.
• Explain benefits, eligibility, and claims clearly.
• Research and resolve inquiries across multiple systems.
• Document interactions for follow-up and QA.
• Collaborate with internal teams to resolve complex issues.
• Adhere to HIPAA and CMS regulations.

Skills

Communication skills

Problem solving

Multitasking

Attention to detail

MS Office

Portal navigation

Education

High School Diploma or GED

Tools

Microsoft Office

Web portals navigation

Job description

WPS Health Solutions is seeking a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will provide detailed responses on benefits, eligibility, and claims, navigating multiple systems to researching and resolving inquiries with clarity and empathy.

The role requires strong communication, accuracy, and the ability to document interactions in the system for QA.