Remote Health Plan Support Specialist

WPS—A health solutions company; Florida; Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or meritincrease

401(k) with employer match

Competitive PTO

Health and dental insurance start DAY

Professional development programs

Job summary

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

The role requires strong communication and problem-solving skills, attention to detail, and the ability to work within Central Time. Remote work options are available for approved states.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ years of customer service in health insurance or healthcare call center.
• Strong verbal and written communication with ability to explain complex information.
• Demonstrated problem-solving with empathy and patience.
• Ability to multitask, prioritize, and manage time in a fast-paced environment.
• Proficiency in Microsoft Office and portal navigation.
• Adherence to structured work schedule based on Central Time.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers regarding benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding benefits, eligibility, claim status and billing issues.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints and issues efficiently to ensure high customer satisfaction.
• Collaborate with internal teams to address complex inquiries and facilitate a seamless experience.
• Document all interactions accurately in the system for follow-up and QA purposes.
• Develop understanding of health plan products and regulatory requirements (HIPAA, CMS).
• Ensure adherence to regulatory guidelines when providing information and service.

Skills

Customer service experience

Verbal and written communication

Problem-solving

Multitasking

Attention to detail

MS Office Suite

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

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

The role requires strong communication and problem-solving skills, attention to detail, and the ability to work within Central Time. Remote work options are available for approved states.