Remote Health Plan Customer Care Associate

WPS Health Solutions; Columbus (OH); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options

Performance bonus

401(k) with matching

Paid time off

Health insurance, dental, telehealth

Development programs

Know Your Rights information

Job summary

WPS Health Solutions in Columbus, OH is seeking a Customer Care Center Rep to provide exceptional service to members, brokers, and providers. You will respond to benefits, eligibility, and claims inquiries with clear, accurate information and research across multiple systems.

You will document interactions, maintain regulatory compliance, and collaborate with internal teams to resolve issues efficiently while upholding a high standard of customer satisfaction.

Qualifications

• 1+ year of customer service in a fast-paced health insurance or healthcare call center environment.
• Strong verbal and written communication with ability to explain complex information.
• Demonstrated problem-solving skills with empathy and patience.
• Proficiency with Microsoft Office and website/portal navigation.

Responsibilities

• Serve as the first contact for members, brokers, and providers regarding benefits, eligibility, claims, billing, and healthcare services.
• Explain benefits, eligibility, claim status, and billing issue resolutions.
• Research inquiries across multiple systems to provide clear, accurate responses.
• Document all interactions for follow-up and quality assurance.
• Collaborate with internal teams to address complex inquiries and ensure a seamless experience.
• Maintain HIPAA and CMS compliance in all communications.

Skills

Customer service

Communication skills

Problem solving

Multitasking

Attention to detail

MS Office

Portal navigation

Schedule adherence

Education

HS Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions in Columbus, OH is seeking a Customer Care Center Rep to provide exceptional service to members, brokers, and providers. You will respond to benefits, eligibility, and claims inquiries with clear, accurate information and research across multiple systems.

You will document interactions, maintain regulatory compliance, and collaborate with internal teams to resolve issues efficiently while upholding a high standard of customer satisfaction.