Health Insurance Customer Service Representative II

1 month ago

Madison, Wisconsin, United States WPS Health Solutions Full time

Who We Are

WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS Health Solutions has been making health care easier for the people we serve for more than 75 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS' Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition

Role Snapshot

Our Customer Service Representative II works in our WPS Health Insurance call center. This role will support our members and providers with inquirers through phone, email, or secured messaging. In addition, this role will provide support on benefits, claims, pre-authorization's and provider verifications.

How do I know this opportunity is right for me? If you:

  • Would enjoy receiving and responding to telephone, written inquiries regarding status of claims, benefits, coordination of benefits, third-party liability, and eligibility.
  • Can utilize pharmacy benefits system to respond to inquiries related to pharmacy coverage and communicate approved authorizations.
  • Have high attention to detail and can assist with collection of customer data for quality purposes to update and enhance product offerings.
  • Want to educate members and providers regarding policies and procedures of health plan.
  • Would enjoy working independently, referring to supervisor for assistance and guidance in handling difficult or unique situations.
  • Have the ability to tailor communications to respond professionally to diverse populations, function independently and in a team setting, and balance multiple tasks simultaneously.
  • Have the ability to understand HIPAA rules and importance of complying with Federal/state laws and regulations along with company rules and guidelines.
  • Possess expertise in Microsoft Office (Outlook, Word, Excel), internet, intranet, and standard office equipment.

What will I gain from this role?

  • Utilizing excellent verbal and written communication, problem-solving, investigative, and organizational skillsets.
  • Many opportunities to resolve inquiries, as well as strengthen customer relationship with WPS staff and customers.
  • Ability to learn about a multitude of areas including:
    • Benefit design for pharmacy.
    • Internal processing systems, web-based systems, resource systems.
    • Benefits compliance, regulations, policies, and procedures.
  • Working in a continuous performance feedback environment.
  • Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries.

Minimum Qualifications

  • High School Diploma or equivalent

Preferred Qualifications

  • 1 or more years of current WPS call center experience is strongly preferred
  • 2 or more years of experience in customer service.
  • 1 or more years of experience with healthcare benefits expertise
  • 1 or more years of experience working in a remote setting.
  • 1 or more years of experience working in a call center.
  • 1 or more years of experience in managed care insurance / healthcare benefits as a Customer Service Representative or Claims Processor.
  • Knowledge of coordination of benefits, Medicare primacy, third-party liability, and other regulations related to claims adjudication.
  • Bilingual: Fluent in Spanish or other languages is preferred

Remote Work Requirements

  • Wired (ethernet cable) internet connection from your router to your computer
  • High speed cable or fiber internet
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at )
  • Please review Remote Worker FAQs for additional information

Additional Information

  • Start Date: Monday, September 23rd, 2024
  • Starting Base Salary: at least $20.50/hour
  • Training Location/Schedule: Mandatory Training. Monday-Friday from 8-4:30pm CT
  • Scheduled Shift: Once trained, 8-hours shifts between 7:30am-5:30pm CT

Work Location

  • We are a remote-first organization and offer remote work in the following approved states:
    Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin
    • To help strengthen communication, provide a sense of community, and improve the overall remote work experience, the assigned office community based on the position's division is: HI: Green Bay, Wisconsin

Benefits

  • Remote work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Employee Resource Groups
  • Professional and Leadership Development Programs
  • Review additional benefits here

Sign up for Job Alerts

FOLLOW US

Instagram

LinkedIn

Facebook

WPS Health Blog



Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR c)

Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.

  • Insurance Customer Service Specialist

    7 days ago

    Madison, Wisconsin, United States Michelle Wenzel Allstate Insurance Full time

    Job OverviewAt Michelle Wenzel Allstate Insurance, we are a distinguished insurance agency dedicated to delivering exceptional service to our clients. As a **Licensed Insurance Customer Service Representative**, you will be instrumental in providing tailored support and guidance to our valued customers.We pride ourselves on fostering a collaborative and...

  • Insurance Customer Service Specialist

    2 days ago

    Madison, Wisconsin, United States Michelle Wenzel Allstate Insurance Full time

    Job OverviewAt Michelle Wenzel Allstate Insurance, we pride ourselves on delivering exceptional service to our clients. As a Licensed Insurance Customer Service Representative, you will be instrumental in providing personalized assistance and support to our valued customers.What We OfferCompetitive Hourly Salary with Commission and Bonus PotentialGenerous...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States SSM Health Full time

    Job SummaryWe are seeking a skilled Customer Service Representative to join our team at SSM Health. As a key member of our Call Center, you will be responsible for providing exceptional customer service and support to our patients and customers.Key ResponsibilitiesRespond to Inquiries: Answer incoming calls and respond to customer inquiries in a timely and...

  • Insurance Customer Care Specialist

    7 days ago

    Madison, Wisconsin, United States Michelle Wenzel Allstate Insurance Full time

    Job OverviewAt Michelle Wenzel Allstate Insurance, we are dedicated to delivering exceptional service to our clients. As a Licensed Insurance Customer Service Representative, you will be instrumental in providing personalized support and guidance to our valued customers.We pride ourselves on fostering a collaborative and welcoming environment where every...

  • Sales and Customer Service Representative

    3 weeks ago

    Madison, Wisconsin, United States American Family Insurance Full time

    You will provide support to customers (insureds, clients, advisors, partners and agencies), and internal and external partners. Develops (or evolves) knowledge necessary to provide expected support. Understand and maintain measurements while living our values.Position Compensation Range:$ $30.76Pay Rate Type:HourlyCompensation may vary based on the job level...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States Capital Senior Living Full time

    Customer Service RepresentativeWe are seeking a skilled Customer Service Representative to join our team at Capital Senior Living. As a key member of our community, you will provide exceptional customer service and care to our senior residents.About the RoleProvide exceptional customer service and care to our residentsBe a dependable and responsible member...

  • Customer Service Representative

    1 month ago

    Madison, Wisconsin, United States Spherion Full time

    We are looking for Customer Service Representatives available to start in August for our client headquartered just outside of Madison, WI. As a Customer Service Representative, you will be a part of a friendly, supportive, team that shows their appreciation through various employee perks.Highlights:- Temporary with the opportunity for permanent hire- Pay...

  • Customer Service Representative

    3 weeks ago

    Madison, Wisconsin, United States Spherion Full time

    We are looking for customer service representatives available to start in September for our client headquartered just outside of Madison, WI. This is an excellent opportunity to join a friendly, supportive, team that shows their appreciation through various employee perksOverview:Temporary with the opportunity for permanent hirePay Rate: $18/hrComprehensive...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States Rose International Full time

    Job Summary:Rose International is seeking a highly skilled professional to provide exceptional customer service to our clients. As a Customer Service Representative, you will be responsible for delivering outstanding service, answering questions, and resolving issues in a timely and professional manner.Key Responsibilities:Provide customer service to clients...

  • Automotive Customer Service Representatives

    1 week ago

    Madison, Wisconsin, United States Vadenchevroletpooler Full time

    Position Overview Join our dynamic team at Vadenchevroletpooler as an Automotive Customer Service Representative. We are dedicated to providing exceptional service and support to our valued customers in the automotive industry. Compensation and Benefits Income: $50,000 to $75,000+ based on performance Benefits: Comprehensive health, dental, and...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States Brett Gerharz - State Farm Agent Full time

    Engaging Role as a Customer Service RepresentativeAre you a personable individual who enjoys assisting others? A position as a representative with a State Farm independent contractor may be an ideal career path for you. State Farm agents are dedicated to marketing State Farm's insurance and financial solutions.Primary DutiesEstablish and nurture customer...

  • Customer Service Representative

    1 week ago

    Madison, Wisconsin, United States Brett Gerharz - State Farm Agent Full time

    Exciting Role as a Customer Service RepresentativeAre you a personable individual who enjoys assisting others? If so, a position as a representative with a State Farm independent contractor may be an ideal career path for you. State Farm agents concentrate solely on promoting State Farm insurance and financial solutions.Core ResponsibilitiesEstablish and...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States Rosen Nissan Madison Full time

    Full-time Customer Service RepresentativeThe Rosen Automotive Group is a leading provider of automotive services in Wisconsin, dedicated to delivering exceptional customer experiences. We are seeking a highly skilled and customer-focused Front Desk Coordinator to join our team at our Nissan Madison location.Job SummaryProvide exceptional customer service and...

  • Customer Service Representative

    2 days ago

    Madison, Wisconsin, United States Twice Daily Full time

    Exciting Opportunity at Twice DailyWe are seeking dedicated and personable Customer Service Representatives to enhance our retail operations. In this role, you will be pivotal in delivering outstanding customer experiences, managing transactions, and ensuring a tidy and welcoming store atmosphere.Key Responsibilities:Assist customers with their purchases and...

  • Insurance Operations Coordinator

    1 week ago

    Madison, Wisconsin, United States Rural Mutual Insurance Full time

    Job OverviewWe are looking for a detail-oriented and experienced Insurance Operations Coordinator to become a vital part of our dedicated team. This essential position focuses on ensuring the precision and effectiveness of our insurance policy management and billing processes. As an Insurance Operations Coordinator, your primary responsibilities will include...

  • Representative II, Operations

    1 month ago

    Madison, Wisconsin, United States NTT DATA Services Full time

    Req ID: NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Representative II, Operations - Med D Prior Auth to join our team in Madison, Mississippi (US-MS), United States...

  • Manufacturing Customer Service Representative

    1 week ago

    Madison, Wisconsin, United States Argus Technical Services Full time

    Position Overview:The Manufacturing Customer Service Representative plays a crucial role in ensuring a seamless experience for our clients. This position is responsible for a variety of tasks that support the operational needs of the organization.Key Responsibilities:1. Serve as the initial point of contact by welcoming and assisting all visitors.2. Manage...

  • Patient Service Representative

    4 days ago

    Madison, Wisconsin, United States Access Community Health Centers, Inc. Full time

    Job SummaryWe are seeking a highly skilled and compassionate Patient Service Representative to join our team at Access Community Health Centers, Inc. As a key member of our healthcare team, you will be responsible for providing exceptional patient care and administrative support to ensure a seamless and efficient experience for our patients.Key...

  • Customer Service Sales Representative

    2 days ago

    Madison, Wisconsin, United States Extra Space Full time

    Retail Sales Associate ($500 Sign-On Bonus)Position OverviewAs a Retail Sales Associate, you will join a vibrant team that values diversity and fosters a positive workplace culture. Extra Space Storage has been recognized among the Top 100 Best Places to Work in 2020 on Glassdoor. We are the fastest-growing storage provider in the nation, boasting over 2,000...

  • Insurance Account Executive

    2 days ago

    Madison, Wisconsin, United States First MainStreet Insurance, L.C. Full time

    POSITION TITLE: Account ManagerREPORTS TO: Operations DepartmentCLASSIFICATION: Exempt EEO CLASSIFICATION: ProfessionalsPOSITION SUMMARY:The Account Manager plays a crucial role in fostering and maintaining relationships with our esteemed clients by addressing their insurance protection requirements. This position involves overseeing a portfolio of accounts,...