Wisconsin Based: Insurance Verification Specialist $18.25

TEKsystems; Menomonie (WI); Remote; Full time

Job summary

A leading company is seeking a Member Experience Representative to manage inquiries related to insurance coverage and claims. This remote role requires proficiency in either Medicare or Group/Marketplace. The representative will ensure clear communication, document interactions, and meet departmental metrics. The position offers competitive pay and a comprehensive benefits package, including medical, dental, and 401(k).

Benefits

Medical insurance

Dental insurance

Vision insurance

401(k)

Life insurance

Disability insurance

HSA

Transportation benefits

Employee Assistance Program

PTO

Qualifications

• Experience in managing Medicare or Group/Marketplace inquiries.
• Ability to translate healthcare jargon into clear communication.

Responsibilities

• Handle inquiries regarding coverage, claim status, and benefit interpretation.
• Document interaction details and follow up on outstanding issues.

Skills

Call center experience

Insurance knowledge

Benefit interpretation

Claims processing

Job description

Job Title: Member Experience Representative

This is a remote role; applicants must reside in Wisconsin.

Job Description

The Member Experience Representative primarily handles inquiries via phone or email from providers, members, customers, or brokers regarding coverage, claim status, benefit interpretation, billing, and authorizations.

Key responsibilities include:

1. Proficiently managing one line of business, either Medicare or Group/Marketplace, and translating healthcare jargon into clear communication.
2. Documenting interaction details and follow-up actions in the database.
3. Aligning behavior with the organization's philosophy, mission, values, and vision.
4. Applying organizational and regulatory principles, procedures, and policies appropriately.
5. Responding efficiently to inquiries within departmental timeframes to meet metrics and standards.
6. Probing during calls to ensure first call resolution.
7. Following up on outstanding issues and escalating as necessary.

Required Skills

• Call center experience
• Insurance knowledge, including Medicare and group insurance
• Benefit interpretation and claims processing skills

Compensation and Schedule

Pay: $18.25/hr

Training Duration: 6-8 weeks, Monday to Friday, 8am to 4pm

Shift Options: Monday to Friday, 8:30am to 5pm or 9am to 5:30pm

Location

Remote in Wisconsin

Benefits

Includes medical, dental, vision, critical illness, accident, hospital coverage, 401(k), life insurance, disability, HSA, transportation benefits, Employee Assistance Program, PTO, vacation, and sick leave.

Application Deadline

May 27, 2025

About TEKsystems

TEKsystems is a leading provider of business and technology services, working with over 6,000 customers globally and a team of 80,000 professionals. We focus on delivering business outcomes and positive community impact.

We are an equal opportunity employer, considering all applications regardless of protected characteristics.