Remote Health Insurance Care Center Rep

WPS Health Solutions; Indianapolis (IN); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and merit increase

Job summary

WPS Health Solutions is seeking a Customer Care Center Representative in a remote capacity. The role handles member, broker, and provider inquiries about benefits, eligibility, and claims with accuracy and empathy. Training is in CT during the first 8 weeks, with standard hours observed thereafter.

The position emphasizes resolving issues, documenting interactions, and staying current on regulatory requirements while delivering clear, professional responses.

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.
• Problem solving with empathy and patience.
• Multitask, prioritize and manage time effectively.
• High accuracy and attention to detail.
• Proficient in Microsoft Office and portal navigation.
• Adhere to a schedule in the central time zone.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers on benefits, eligibility, claims, billing, and services.
• Help members understand benefits, eligibility, and claim status; resolve billing issues.
• Respond to provider inquiries about claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints, and issues with efficiency.
• Collaborate with internal teams for complex inquiries and seamless experiences.
• Review information across systems to resolve inquiries with clear, professional responses.
• Document all interactions for follow-up and quality assurance.
• Develop understanding of health plan products; stay updated on policies and regulations.
• Ensure HIPAA and CMS compliance when providing information.
• Other responsibilities as required.

Skills

Communication

Problem solving

Multitasking

Attention to detail

Time management

Education

High School Diploma or GED

Tools

Microsoft Office

Portal navigation

Facets

NTT

Job description

WPS Health Solutions is seeking a Customer Care Center Representative in a remote capacity. The role handles member, broker, and provider inquiries about benefits, eligibility, and claims with accuracy and empathy. Training is in CT during the first 8 weeks, with standard hours observed thereafter.

The position emphasizes resolving issues, documenting interactions, and staying current on regulatory requirements while delivering clear, professional responses.