Remote Health Plan Support Specialist

WPS Health Solutions; Newark (NJ); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote options

Performance bonus

401(k) match

Paid time off

Health insurance

Job summary

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

Join a team that emphasizes HIPAA compliance, detailed documentation, and continuous learning of policy updates. Remote work options are available; training is conducted in CT during first 8 weeks.

Qualifications

• 1+ year of customer service in health insurance or healthcare call center.
• Strong verbal and written communication with ability to explain complex information clearly.
• 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.
• Ability to adhere to a structured work schedule based around Central Time.

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; resolve billing issues.
• 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 handle complex inquiries and ensure a seamless experience.
• Accurately document all interactions in the system for follow-up and QA.

Skills

Customer service

Communication skills

Problem solving

Multitasking

Attention to detail

Time management

MS Office

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 respond to inquiries about benefits, eligibility, and claims, and research issues across multiple systems to provide clear, accurate answers.

Join a team that emphasizes HIPAA compliance, detailed documentation, and continuous learning of policy updates. Remote work options are available; training is conducted in CT during first 8 weeks.