Remote Member Care Specialist

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

Benefits offered by this job

Remote work options

Performance bonus

401(k) with generous company match

Paid time off

Health insurance

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 respond to health plan inquiries, resolve issues with empathy, and document interactions accurately across multiple systems.

The role offers remote work in approved states, a starting base salary of $20.50/hr, and a structured training period. Training is Mon-Fri CT for the first 8 weeks, with a 8:30am-5:00pm CT schedule once trained.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ year of customer service in a fast-paced, high-volume health insurance or healthcare call center.
• Strong verbal and written communication skills with ability to explain complex information.
• Demonstrated problem-solving skills 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/portal navigation.
• Ability to adhere to a structured work schedule based around the central time zone.

Responsibilities

• Serve as the first contact for members, brokers, and providers with inquiries regarding benefits, eligibility, claims, billing, and healthcare services.
• Assist members in understanding their benefits, eligibility, claim status, and resolution of 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 levels of customer satisfaction.
• Collaborate with internal teams to address complex inquiries and facilitate a seamless experience.
• Review information across multiple systems to resolve inquiries with clear, professional responses.
• Develop understanding of health plan products and regulatory requirements; learn updates as they happen.
• Ensure adherence to HIPAA and CMS guidelines when providing information and service.

Skills

Verbal and written communication

Multitasking

Attention to detail

Problem-solving

Empathy

Education

High School Diploma or GED

Tools

Facets

NTT

Microsoft Office

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 respond to health plan inquiries, resolve issues with empathy, and document interactions accurately across multiple systems.

The role offers remote work in approved states, a starting base salary of $20.50/hr, and a structured training period. Training is Mon-Fri CT for the first 8 weeks, with a 8:30am-5:00pm CT schedule once trained.