Remote Health Plan Support Specialist

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

Benefits offered by this job

Remote work options

Bonus opportunities

401(k) with match

Health insurance

PTO

Job summary

WPS—A health solutions company is seeking a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will research and respond to questions about benefits, eligibility, and claims with clear, accurate language across multiple systems.

The role requires a high school diploma, 1+ year health insurance call center experience, strong communication, empathy, and accuracy, plus proficiency with Microsoft Office and portals.

Qualifications

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

Responsibilities

• Serve as the first point of contact for members, brokers, and providers on benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding benefits, eligibility, claim status, and billing issue resolution.
• 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 resolve complex inquiries and ensure a seamless experience.
• Document all interactions thoroughly in the system for follow-up and QA.

Skills

Customer service

Verbal and written communication

Multitasking

Attention to detail

HIPAA compliance

MS Office

Portal navigation

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS—A health solutions company is seeking a Customer Care Center Representative to deliver exceptional service to members, brokers, and providers. You will research and respond to questions about benefits, eligibility, and claims with clear, accurate language across multiple systems.

The role requires a high school diploma, 1+ year health insurance call center experience, strong communication, empathy, and accuracy, plus proficiency with Microsoft Office and portals.