Remote Health Plan Support Specialist

WPS Health Solutions; Hampton (VA); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus

401(k) with generous match

Health insurance starting DAY 1

Paid time off

Professional development

Job summary

WPS Health Solutions is seeking a Customer Care Center Representative to deliver exceptional support to members, brokers, and providers. You will research inquiries across multiple systems and provide clear, accurate responses in a compliant manner.

The role requires strong communication, empathy, and the ability to multitask in a fast-paced environment. Training is conducted CT time, with regular CST schedules and remote options available for qualified states.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ years of customer service in a fast-paced health insurance or healthcare call center.
• Strong verbal and written communication skills.
• Problem-solving with empathy and patience.
• Multitask efficiently in a fast-paced environment.
• High accuracy and attention to detail.
• Proficiency in Microsoft Office and portal navigation.
• Ability to work a schedule centered around Central Time.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers with inquiries about benefits, eligibility, and claims.
• Explain complex information clearly and accurately.
• Resolve billing issues and assist with claim status updates.
• Address provider inquiries regarding claims, authorizations, and reimbursement status.
• Document all interactions in the system for follow-up and QA purposes.
• Learn health plan products and regulatory requirements.
• Adhere to HIPAA and CMS guidelines when providing information and service.
• Collaborate with internal teams to resolve complex inquiries.

Skills

Customer service

Verbal communication

Written communication

Multitasking

Attention to detail

Microsoft Office

Portal navigation

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions is seeking a Customer Care Center Representative to deliver exceptional support to members, brokers, and providers. You will research inquiries across multiple systems and provide clear, accurate responses in a compliant manner.

The role requires strong communication, empathy, and the ability to multitask in a fast-paced environment. Training is conducted CT time, with regular CST schedules and remote options available for qualified states.