Medicare Customer Service Rep II

WPS Health Solutions; Bridgeport (CT); Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a dedicated Customer Service Representative to join their remote team. This role involves responding to provider inquiries, educating customers on coverage and claims, and utilizing self-service tools to enhance customer experience. With a focus on Medicare guidelines, you will be part of a recognized contact center that values teamwork and continuous feedback. Enjoy the flexibility of remote work while contributing to a mission-driven organization that supports military personnel and Medicare beneficiaries. If you have a passion for helping others and a knack for problem-solving, this opportunity is perfect for you.

Benefits

Remote Work Options

401(k) with Immediate Vesting

Health and Dental Services from Day 1

Performance Bonus Opportunities

Competitive Paid Time Off

Professional Development Programs

Qualifications

• 1+ years of customer service experience with health insurance or Medicare claims.
• Ability to learn and apply Medicare guidelines and self-service tools.

Responsibilities

• Respond to provider inquiries via telephone and educate on coverage and claims.
• Establish rapport with contacts and present a favorable corporate image.

Skills

Customer Service

Medicare Guidelines

Insurance Terminology

Problem Solving

Communication Skills

Education

High School Diploma

Job description

This position will respond to telephone inquiries from providers or their representatives. Establish and maintain rapport with contacts and present a favorable corporate image. Educate customers on coverage, claim submission, and use of self-service offerings.

• Receive and respond to a wide range of provider inquiries received via telephone.
• Educate providers on coverage, claim submission, and self-service options available 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

How do I know this opportunity is right for me? If you:

• Can learn and apply Medicare guidelines and computer-based self-service tools.
• Have knowledge of or can learn insurance and medical terminology.
• Can identify customer issues, research, and initiate appropriate actions. Communicate confidently and clearly with customers.
• Can navigate multiple computer applications.
• Ask probing questions to identify issues.

What will I gain from this role?

• Enhanced knowledge of Medicare guidelines.
• Be part of a successful team; the GHA Contact Center was awarded Best Small Contact Center by ICMI.
• Experience serving our Nation's military, veterans, Guard and Reserves, and Medicare beneficiaries.
• Continuous performance feedback.

Minimum Qualifications

• High School diploma or equivalent.
• 1+ years of customer service experience with health insurance and/or Medicare/DME claims.
• 1+ years of customer service experience via telephone.

Preferred Qualifications

• 1+ years of previous customer service at WPS or as a contracted Medicare CSR II at WPS.
• 1+ years recent Medicare or healthcare insurance experience.
• 2+ years of call center experience.
• Coursework in coding, medical terminology, or understanding of general medical terminology.
• Coursework in Business Administration, Communications, or related fields.

Remote Worker Requirements: Must meet remote work requirements, including a designated workstation, wired Ethernet connection, and minimum internet speed of 10Mbps downstream and 1Mbps upstream.

Benefits

• Remote and hybrid work options.
• Performance bonus and merit increase opportunities.
• 401(k) with immediate 100% vesting for the first 3% match, and 50% for the next 2%.
• Competitive paid time off.
• Health, dental, and telehealth services from DAY 1.
• Professional and Leadership Development Programs.

Who We Are

WPS Health Solutions is a leading not-for-profit health insurer and federal contractor based in Wisconsin, serving individuals, families, seniors, and military personnel across the U.S. for over 75 years.

Culture Drives Our Success

We foster an open, empowering, and inclusive employee experience, recognized for our workplace culture and awards.

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