Remote Health Insurance Customer Care Rep

WPS Health Solutions; Madison (WI); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus or merit increase

401(k) with generous matching

Competitive paid time off

Health and dental insurance starting 1

Job summary

WPS Health Solutions is seeking a Customer Care Center Representative to support members, brokers, and providers. You will research and respond to health plan inquiries with accurate information, while maintaining HIPAA-compliant, patient-focused service.

The role requires strong communication, empathy, and the ability to navigate multiple systems to resolve issues efficiently. Training spans 8 weeks, with shifts Monday–Friday and core hours in CT.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ years of customer service in health insurance or healthcare call center.
• Strong verbal and written communication, ability to explain complex info.
• Demonstrated problem-solving with empathy and patience.
• Multitask, prioritize, and manage time in a fast-paced environment.
• Accurate with detail; proficient in MS Office and portal navigation.
• Must adhere to a structured schedule around Central Time.

Responsibilities

• Serve as the first contact for members, brokers, and providers regarding benefits, eligibility, claims, and billing.
• Explain benefits, eligibility, claim status, and resolution of billing issues clearly.
• Respond to provider inquiries about claims, authorizations, and reimbursements.
• Resolve service requests and issues with high customer satisfaction.
• Document all interactions in the system for follow-up and QA.
• Develop understanding of health plan products and regulatory requirements.

Skills

Customer service

Verbal communication

Written communication

Multitasking

Attention to detail

MS Office

Portal navigation

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions is seeking a Customer Care Center Representative to support members, brokers, and providers. You will research and respond to health plan inquiries with accurate information, while maintaining HIPAA-compliant, patient-focused service.

The role requires strong communication, empathy, and the ability to navigate multiple systems to resolve issues efficiently. Training spans 8 weeks, with shifts Monday–Friday and core hours in CT.