Remote Health Plan Support Specialist

WPS—A health solutions company; Minnesota; 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 full match for first 3%

50% match for next 2%

Competitive paid time off

Health insurance and telehealth from 1

Professional and LeadershipDevelopment

Career benefits link

Job summary

WPS, a health solutions company, is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research benefits, eligibility, and claims, providing clear, accurate responses while navigating multiple systems.

The role starts with training in Central Time and progresses to a 8:30am-5:00pm CT schedule, with remote work options in approved states and a starting wage of $20.50 per hour.

Qualifications

• High School Diploma or GED or equivalent experience.
• One (1) or more years of customer service experience in a fast paced, high-volume health insurance or healthcare call center environment.
• Strong verbal and written communication skills with the ability to effectively explain complex information.
• Demonstrated problem-solving skills with the ability to handle difficult situations with empathy and patience.
• Solid ability to multitask, prioritize, and manage time effectively in a fast-paced environment.
• Ability to maintain a high level of accuracy and attention to detail.
• Proficiency in Microsoft Office Suite and website and/or portal navigation.
• Ability to adhere to a structured work schedule based around the central time zone.

Responsibilities

• Serve as the first point of contact for members, brokers, and medical providers, answering inquiries regarding benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding their benefits, eligibility, claim status and the resolution of billing issues.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints and issues efficiently, ensuring high levels of customer satisfaction.
• Collaborate with internal teams to address complex inquiries and facilitate a seamless experience.
• Review detailed information across multiple systems to accurately resolve inquiries while delivering clear, professional, and thorough responses.
• Accurately document all interactions in the system, ensuring thorough record-keeping for follow-up actions and quality assurance purposes.
• Develop a thorough understanding of health plan products and services, actively learning updates to policies, procedures, and regulatory requirements.
• Ensure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing information and service to members, providers or brokers.
• Other job-related responsibilities may be assigned as required.

Skills

Customer service

Communication

Multitasking

Time management

Education

High School Diploma or GED

Tools

Microsoft Office

Portal navigation

Job description

WPS, a health solutions company, is seeking a Customer Care Center Rep to deliver exceptional service to members, brokers, and providers. You will research benefits, eligibility, and claims, providing clear, accurate responses while navigating multiple systems.

The role starts with training in Central Time and progresses to a 8:30am-5:00pm CT schedule, with remote work options in approved states and a starting wage of $20.50 per hour.