Medicare Customer Service Rep II

WPS Health Solutions; Atlanta (GA); Remote; USD 10,000 - 60,000; Full time

Job summary

Join a leading not-for-profit health insurer as a Customer Service Representative in a fully remote role. This position offers the chance to engage with providers, educate them on coverage and claims, and utilize self-service tools to enhance their experience. You'll be part of a recognized team, gaining valuable insights into Medicare guidelines while enjoying the flexibility of remote work. With a supportive culture that values innovation and diversity, this is an opportunity to make a meaningful impact in the healthcare sector.

Benefits

401(k) with full match

Paid time off

Health and dental benefits

Performance bonuses

Professional development programs

Remote work options

Qualifications

• 1+ years of customer service experience, preferably in health insurance.
• Ability to learn Medicare guidelines and use self-service tools.

Responsibilities

• Respond to provider inquiries and educate on coverage and claims.
• Maintain rapport with contacts and present a favorable image.

Skills

Customer Service

Insurance Knowledge

Communication Skills

Problem Solving

Computer Navigation

Education

High School Diploma

Job description

This position will respond to telephone inquiries from providers or their representatives. It involves establishing and maintaining rapport with contacts and presenting a favorable corporate image. The role includes educating customers on coverage, claim submission, and the use of self-service tools.

1. Receive and respond to a wide range of provider inquiries received via telephone.
2. Educate providers on coverage, claim submission, and how to use self-service offerings via the Integrated Voice Response (IVR) and Portal.

Additional Information

• Start Date: Tuesday, June 17^th, 2025
• Starting Pay: $19.60/hour
• Training Schedule: First 6 weeks, Monday-Friday, 7:30am-4:05pm CST
• Scheduled Shift: Monday-Friday, 8:30am-5:05pm CST
• Work from Home: This is a 100% remote opportunity within approved states.

We are open to remote work in the following approved states: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin.

Candidate Suitability

Ideal candidates will:

• Learn and apply Medicare guidelines and use computer-based self-service tools.
• Possess knowledge of or ability to learn insurance and medical terminology.
• Identify customer issues, research, and initiate appropriate actions, communicating confidently and clearly.
• Navigate multiple computer applications efficiently.
• Ask probing questions to clarify issues.

Benefits of the Role

• Enhanced understanding of Medicare guidelines.
• Be part of a successful team recognized as the Best Small Contact Center by the International Customer Management Institute (ICMI).
• Gain experience serving military personnel, veterans, Guard, Reserves, and Medicare beneficiaries.
• Receive ongoing performance feedback.

Minimum Qualifications

• High School diploma or equivalent.
• At least 1 year of customer service experience working with health insurance or Medicare/DME claims.
• At least 1 year of customer service experience via telephone.

Preferred Qualifications

• Experience at WPS or as a contracted Medicare CSR II at WPS.
• Recent Medicare or healthcare insurance experience.
• 2+ years of call center experience.
• Coursework in coding, medical terminology, or related fields.
• Coursework in Business Administration or Communications.

Remote Work Requirements

Must have a designated workstation, wired Ethernet connection, and a minimum internet speed of 10 Mbps downstream and 1 Mbps upstream.

Benefits

• Remote and hybrid work options.
• Performance bonuses and merit increases.
• 401(k) with full match for the first 3%, and partial for the next 2%.
• Paid time off, health, dental, and telehealth benefits from day one.
• Professional development programs.
• Additional benefits details at this link.

About WPS Health Solutions

A leading not-for-profit health insurer and federal contractor based in Wisconsin, serving military, veterans, and Medicare beneficiaries for over 75 years, committed to making healthcare easier.

Our Culture

We foster an open, empowering environment that values diversity, innovation, and authentic engagement, recognized with awards for our workplace culture.

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