What are the responsibilities and job description for the Customer Care Specialist, Pay is $17.00/hr, Start Date- September 11th (Must liv position at WPS Health Solutions?
Who We Are
is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small to large businesses. We process claims and provide customer service 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. In 2021, WPS Health Solutions celebrates of making health insurance easier for those we serve. Proud to be military and veteran ready.
Our Culture
WPS' Performance-Based Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive, empowering employee experience, focusing on People, Work, and Conditions. 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 guided by our Purpose: Together, making health care easier for the people we serve.
In 2021 & 2022, WPS Health Solutions was recognized for several awards including:
Role Snapshot
Answer inquiries from beneficiaries, providers, and other affiliated representatives or groups regarding TRICARE eligibility, benefit determinations, and claims adjudication questions or problems.
In this role you will:
- Receive telephone, written, fax, and e-mail inquiries concerning TRICARE eligibility, benefits determinations, and claims adjudication questions or billing problems.
- Apply appropriate provisions of TRICARE regulations, interpretations, and procedural directives in making determinations on eligibility and benefits to determine appropriate responses to inquiries.
- Obtain and analyze claims data to determine specific problem area including external communication to obtain data.
- Complete research and provide final resolution to inquiries within contractual requirements.
- Communicate with inquirer to determine appropriate authorization or referral of services.
- Submit claims for adjudication, correction, payment, or review as appropriate.
- Educate providers on billing requirements of TRICARE to reduce claim problems.
- Deal tactfully with people in a wide variety of situations to convey a favorable corporate image.
- Respond to inquirer using various forms of communication (written letter, telephone, web, or email) within time frames to exceed contractual standards.
- Collect and record data for Customer Service records and computer analysis.
- Inform supervisory staff of system problems when identified, researching problems to provide backup data and examples when needed.
How do I know this opportunity is right for me? If you:
- Enjoy working in a high-volume call center
- Excel at providing timely, accurate answers via telephone by employing strong listening skills
- Enjoy new challenges and approach each day with a positive attitude
- Demonstrate a strong work ethic with a history of dependability and respect
- Possess excellent information retention capabilities
- Thrive in an environment that offers opportunities for continuous learning
What will I gain from this role?
- Gaining experience working in a call center environment
- Having the ability to work remotely from home
- Building in-depth communication and customer service skills
- Being a part of a fun, supportive team that offers great advancement opportunities throughout the organization
- Working in an environment that serves our Nation's military, veterans, Guard and Reserves along with their families
Minimum Qualifications
- U.S. citizenship is required for this position due to Department of Defense restrictions
- High school diploma or equivalent
- 2 or more years of experience in customer service
- Ability to learn medical and insurance terminology
Preferred Qualifications
- Microsoft Office Experience
- Ability to navigate dual monitor screens and between multiple programs at once
- Strong skillsets in multi-tasking, research, and problem-solving
Additional Information
- Start Date: Monday, September 11th, 2023
- Starting Base Salary: $17.00/hr
- Training Location/Schedule:
- Week 1 - Remote (Onsite Optional) - Monday-Friday (September 11th-September 15th ) 8:25 a.m.- 5:00 p.m. CST
- Week 2 - Onsite (Required) - Monday-Friday (September 18th-September 22nd) 8:25 a.m. - 5:00 p.m. CST
- Remaining 2-6 weeks - Remote (Onsite Optional) - Monday-Friday 8:25 a.m. - 5:00 p.m. CST
- All Onsite training will take place at the WPS Corporate Center Building (1717 W. Broadway) in Madison, WI
- Scheduled Work Shift: 24/5 call center. Schedule will be determined by shift bids for 8- hour shifts between Monday-Friday (later ending or overnight shift may be required for a short period of time)
- Work Location: . Once training is complete (training includes one week of required onsite training at our Madison campus) you will have the option to work remote or onsite. Please note that the assigned office for this position is in Madison, WI and remote employees may be required to work at this location at times.
Next steps
After submitting your application, we will send you an online assessment. We recommend you try and complete it within two business days. You must complete and obtain a passing score on the assessment to be considered for the position.
Benefits
- Remote and hybrid 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, dental insurance, Teladoc starts DAY 1
- Review additional benefits
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Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.
Salary : $17 - $0