Medicare Customer Service Rep II

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

Job summary

An established industry player in health solutions is seeking a Medicare Customer Service Representative II to join their dynamic team. This remote role offers the chance to engage with providers, educate them on coverage and claims, and utilize self-service tools. Candidates will gain valuable experience in Medicare guidelines and contribute to a recognized team in the contact center industry. With a focus on effective communication and problem-solving, this position promises professional growth and the opportunity to make a meaningful impact in the lives of military personnel and Medicare beneficiaries.

Benefits

Remote and hybrid work options

Performance bonuses and merit increases

401(k) with immediate vesting

Paid time off

Health, dental, and telehealth benefits from DAY 1

Professional development programs

Qualifications

• 1+ year of customer service experience with health insurance or Medicare claims.
• Ability to learn insurance and medical terminology.

Responsibilities

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

Skills

Effective communication skills

Knowledge of Medicare guidelines

Proficiency in navigating computer applications

Ability to identify customer issues

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

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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.

1. Receive and respond to a wide range of provider inquiries received via telephone.
2. Educate providers on coverage, claim submission, and the use of self-service tools 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 approved remote worker states.

Remote Work Eligible 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 Qualities

• Ability to learn and apply Medicare guidelines and self-service tools.
• Knowledge of or ability to learn insurance and medical terminology.
• Ability to identify customer issues, research, and initiate appropriate actions.
• Effective communication skills for discussing concerns with customers.
• Proficiency in navigating multiple computer applications.
• Ability to ask probing questions to identify issues.

What You Will Gain

• Enhanced knowledge of Medicare guidelines.
• Being part of a successful team recognized as the Best Small Contact Center by ICMI.
• Experience serving military, veterans, and Medicare beneficiaries.
• Continuous performance feedback.

Minimum Qualifications

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

Preferred Qualifications

• Previous customer service experience at WPS or as a contracted Medicare CSR II
• Recent Medicare or healthcare insurance experience
• 2+ years of call center experience
• Coursework in coding, medical terminology, business administration, or communications

Remote Worker Requirements

Designated workstation, wired Ethernet connection, minimum 10Mbps downstream and 1Mbps upstream speed.

Benefits

• Remote and hybrid work options
• Performance bonuses and merit increases
• 401(k) with immediate vesting
• Paid time off
• Health, dental, and telehealth benefits from DAY 1
• Professional development programs

About WPS

WPS Health Solutions is a non-profit health insurer and federal contractor based in Wisconsin, serving individuals, families, seniors, and military personnel for over 75 years.