Medicare Customer Service Rep II

WPS—A health solutions company; North Carolina; Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a Medicare Customer Service Representative to join their team. This role involves responding to inquiries from providers, educating them on coverage and claims, and utilizing self-service tools effectively. With a strong emphasis on customer service, you will enhance your understanding of Medicare guidelines while being part of a recognized team. This remote opportunity offers a supportive environment where your contributions will be valued, and you can grow professionally in a rewarding field.

Benefits

401(k) with matching

Health insurance

Dental insurance

Remote work options

Competitive paid time off

Professional development programs

Qualifications

• 1+ years of customer service experience with health insurance.
• Ability to learn and apply Medicare guidelines.

Responsibilities

• Respond to provider inquiries via telephone.
• Educate customers on coverage and claim submission.

Skills

Medicare guidelines

Insurance and medical terminology

Customer service skills

Computer navigation

Probing questions

Education

High School diploma or equivalent

Job description

Join to apply for the Medicare Customer Service Rep II role at WPS—A health solutions company

6 days ago Be among the first 25 applicants

Join to apply for the Medicare Customer Service Rep II role at WPS—A health solutions company

This position will respond to telephone inquiries from provider or 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 the telephone.
• Educate providers on coverage, claim submission, and use the self-service offerings available via the Integrated Voice Response (IVR) and Portal.
  
  

Additional Information

• Start Date: Tuesday, June 17th, 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 any of our approved remote worker 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:

• Ability to learn and apply Medicare guidelines and computer-based self-service tools.
• Knowledge of or ability to learn and apply insurance and medical terminology.
• Ability to identify customers issues, research, and initiate appropriate action. *Ability to communicate with confidence and clarity when discussing concerns with customers.
• Ability to navigate through multiple computer applications.
• Ability to ask probing questions to identify issues.
  
  

What will I gain from this role?

• Enhanced learning of Medicare guidelines.
• Being part of a successful team. The GHA Contact Center was awarded Best Small Contact Center by the International Customer Management Institute (ICMI).
• Experience working in an environment that serves our Nation’s military, veterans, Guard and Reserves and Medicare beneficiaries
• Continuous performance feedback
  
  

Minimum Qualifications

• High School diploma or equivalent
• 1 or more years of customer service experience working with health insurance and/or Medicare/DME claims.
• 1 or more years of customer service experience with direct contact with customers via telephone
  
  

Preferred Qualifications

• 1 or more years of previous customer service experience at WPS OR Experience working as a contracted Medicare CSR II at WPS.
• 1 or more years recent Medicare or health care insurance experience
• 2 or more years of call center experience
• Coursework in coding and/ or medical terminology or understanding of general medical terminology.
• Coursework in Business Administration, Communications, or related field.
  
  

Remote Worker Requirements: For remote position, employee is required to meet remote worker requirements, including a designated workstation, a wired (Ethernet) connection to the network, and a minimum of 10Mbps downstream connection with at least 1Mbps upstream (can be checked at https://speedtest.net)

Benefits

• Remote and hybrid 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/fulltime_benefits.shtml)
  
  

Who We Are

WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in 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 Health Solutions has been making health care easier for the people we serve for more than 75 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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