Remote Health Plan Support Specialist

KARIER; Colorado; Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and merit increases

401(k) with 100% match for first 3% of

Health insurance starting DAY 1

Professional development programs

Job summary

WPS seeks a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries, resolve issues with empathy, and document interactions across multiple systems for accurate follow-up.

The role requires handling benefits, eligibility, and claims questions, with training held for eight weeks and a fixed schedule once fully trained. Remote work is available in approved states, including Colorado.

Qualifications

• High School Diploma or GED or equivalent experience.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers; answer inquiries regarding benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding benefits and claim status; resolve billing issues.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints, and issues with high customer satisfaction.
• Collaborate with internal teams to handle complex inquiries and ensure a seamless experience.
• Review detailed information across multiple systems to research and resolve inquiries with clear, accurate responses.
• Document all interactions in the system for follow-up and quality assurance.

Skills

Customer service

Verbal and written communication

Problem solving

Multitasking & time management

Attention to detail

Schedule adherence

Microsoft Office & portals navigation

Education

High School Diploma or GED or equivalent experience

Tools

Facets

NTT

Microsoft Office

Job description

WPS seeks a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research health plan inquiries, resolve issues with empathy, and document interactions across multiple systems for accurate follow-up.

The role requires handling benefits, eligibility, and claims questions, with training held for eight weeks and a fixed schedule once fully trained. Remote work is available in approved states, including Colorado.