Remote Health Plan Care Specialist

WPS Health Solutions; Charleston (SC); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options

Performance bonus

401(k) match

Paid time off

Health insurance

Dental insurance

Telehealth

Professional development

Job summary

WPS Health Solutions seeks a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries, resolve eligibility and claims questions, and clearly communicate outcomes across multiple systems.

Training lasts 8 weeks, 8:00-4:30 CT, with full-time Mon-Fri at CST. Remote work is available in approved states; starting base salary is $20.50/hr.

Qualifications

• Minimum 1 year of customer service experience in health insurance or healthcare call center.
• Strong verbal and written communication with ability to explain complex information.
• Demonstrated problem-solving skills with empathy and patience.
• Ability to multitask and manage time effectively in a fast-paced environment.
• Proficiency with Microsoft Office and navigating websites/portals.
• Ability to adhere to a structured work schedule in Central Time zone.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers on benefits, eligibility, claims, and billing.
• Explain benefits, eligibility status, and claim details clearly and accurately.
• Respond to provider inquiries related to claims, authorizations, and reimbursements.
• Resolve service requests and issues with high customer satisfaction.
• Document interactions in the system for follow-up and quality assurance.
• Keep up-to-date on health plan products, policies, and regulatory requirements.

Skills

Customer service

Communication

Problem solving

Multitasking

Attention to detail

MS Office

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions seeks a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries, resolve eligibility and claims questions, and clearly communicate outcomes across multiple systems.

Training lasts 8 weeks, 8:00-4:30 CT, with full-time Mon-Fri at CST. Remote work is available in approved states; starting base salary is $20.50/hr.