Health Plan Support Specialist (Remote)

WPS Health Solutions; Des Moines (IA); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or merit

401(k) with 100% match for the first 3

Job summary

WPS Health Solutions seeks a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries across multiple systems, delivering clear and accurate responses with empathy and care.

Responsibilities include handling benefits questions, eligibility, and claims; ensuring regulatory compliance and thorough documentation; and collaborating with internal teams to resolve complex inquiries. Training emphasizes HIPAA and CMS guidelines.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ year of customer service in health insurance or healthcare call center.
• Strong verbal and written communication; explain complex information.
• Empathetic problem-solving; handle difficult situations.
• Accurate, detail-oriented, able to multitask in a fast-paced environment.
• Proficient in Microsoft Office Suite and portal navigation.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers.
• Explain benefits, eligibility, claims, billing and services clearly.
• Assist members with benefits understanding and claim status.
• Respond to provider inquiries about claims and authorizations.
• Resolve service requests and issues to maintain satisfaction.
• Document interactions accurately in the system for follow-up.

Skills

Customer service

Communication

Multitasking

Attention to detail

Microsoft Office

Portal navigation

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions seeks a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries across multiple systems, delivering clear and accurate responses with empathy and care.

Responsibilities include handling benefits questions, eligibility, and claims; ensuring regulatory compliance and thorough documentation; and collaborating with internal teams to resolve complex inquiries. Training emphasizes HIPAA and CMS guidelines.