Remote Health Plan Support Specialist

WPS Health Solutions; Detroit (MI); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options

Performance bonus opportunities

401(k) with match

Paid time off

Health insurance from DAY 1

Job summary

WPS Health Solutions in Detroit, MI is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research insurance inquiries, resolve issues with clarity and empathy, and document each interaction for follow-up.

Training begins with 8 weeks of CT time, then full scheduling supports benefits, eligibility, and claims questions. The role emphasizes accurate, compliant responses and collaboration with internal teams to ensure a smooth customer

Qualifications

• 1+ year of customer service in health insurance or healthcare call center.
• Ability to explain complex information clearly to diverse populations.
• Empathy and patience in difficult situations.
• Accurate, detail-oriented, and able to multitask in a fast-paced environment.
• Proficient in Microsoft Office and portal navigation.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers regarding benefits, eligibility, claims, billing, and services.
• Assist members in understanding benefits, eligibility, and claim status.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints, and issues efficiently.
• Collaborate with internal teams to address complex inquiries and improve experience.
• Review information across multiple systems to resolve inquiries with clear, professional responses.
• Document all interactions in the system for follow-up actions and QA purposes.
• Develop understanding of health plan products and updates to policies and procedures.
• Ensure adherence to HIPAA and CMS guidelines when providing information.
• Other job-related responsibilities may be assigned.

Skills

Customer service

Verbal & written communication

multitasking

Attention to detail

Microsoft Office

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Portal navigation

Job description

WPS Health Solutions in Detroit, MI is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research insurance inquiries, resolve issues with clarity and empathy, and document each interaction for follow-up.

Training begins with 8 weeks of CT time, then full scheduling supports benefits, eligibility, and claims questions. The role emphasizes accurate, compliant responses and collaboration with internal teams to ensure a smooth customer