Remote Health Plan Care Advocate

WPS—A health solutions company; Ohio; À distance; USD 23 000 - 33 000; Plein temps

Avantages offerts par ce poste

Remote work options

Performance bonus

401(k) match

Paid time off

Health/dental/telehealth start DAY 1

Professional development

Benefits portal access

Résumé du poste

WPS Health Solutions is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will provide detailed responses to health plan inquiries, resolve issues with empathy, and document interactions accurately across systems.

Training is conducted for the first 8 weeks, with a full-time schedule Monday–Friday in Central Time. Remote work is approved in multiple states including Ohio.

Qualifications

• High School Diploma or GED or equivalent experience.
• One (1) or more years of customer service experience in a fast paced health insurance or healthcare call center.
• Strong verbal and written communication skills with the ability to effectively explain complex information.
• Demonstrated problem-solving skills with empathy and patience.
• Solid ability to multitask, prioritize, and manage time effectively in a fast-paced environment.
• Ability to maintain a high level of accuracy and attention to detail.
• Proficiency in Microsoft Office Suite and website/portal navigation.
• Ability to adhere to a structured work schedule based around the central time zone.

Responsabilités

• Serve as the first point of contact for members, brokers, and medical providers, answering inquiries regarding benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding their benefits, eligibility, claim status and the resolution of billing issues.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints and issues efficiently, ensuring high levels of customer satisfaction.
• Collaborate with internal teams to address complex inquiries and facilitate a seamless experience.
• Review detailed information across multiple systems to accurately resolve inquiries while delivering clear, professional, and thorough responses, that are easy to understand by a diverse population.
• Accurately document all interactions in the system, ensuring thorough record-keeping for follow-up actions and quality assurance purposes.
• Develop a thorough understanding of health plan products and services, actively learning updates to policies, procedures, and regulatory requirements.
• Ensure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing information and service to members, providers or brokers.

Connaissances

Customer service

Communication skills

Multitasking

Attention to detail

Formation

High School Diploma or GED

Outils

Microsoft Office Suite

Website/Portal navigation

Description du poste

WPS Health Solutions is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will provide detailed responses to health plan inquiries, resolve issues with empathy, and document interactions accurately across systems.

Training is conducted for the first 8 weeks, with a full-time schedule Monday–Friday in Central Time. Remote work is approved in multiple states including Ohio.