Customer Service Rep III , starting pay $15.02 + shift differentials
Company: WPS Health Solutions
Posted on: February 16, 2020
If you have a mindset for great customer service, now is your
chance to take advantage of this skillset while directly serving
active military, veterans, and their families! Answer inquiries
from beneficiaries, providers, and other affiliated representatives
or groups regarding TRICARE eligibility, benefit determinations,
and claims adjudication questions or problems. Establish and
maintain rapport with contacts and present a favorable corporate
image while responding to inquiries within time frames required to
exceed contractual standards.
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
- 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
- Educate providers on billing requirements of TRICARE to reduce
- 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
- Inform supervisory staff of system problems when identified,
researching problems to provide backup data and examples when
This role could be a good fit if you:
- Possess a customer-service mindset and enjoy conversing with
customers over the phone
- Are a proactive learner with an inquisitive mind who asks
questions and seeks out resources and opportunities for ongoing
- Have the passion and willingness to learn medical and insurance
- Thrive in a supportive, fast-paced work environment
You'll benefit from this experience by:
- Gaining experience working in a call center environment and
learning contract compliance
- Building in-depth communication skills
- Working within a fun, supportive team that offers great
advancement opportunities throughout the organization
- Working remotely once all training is complete and performance
expectations are met
- Receiving medical and dental benefits starting on 1st day of
- Being a part of an environment that serves our Nation's
military, veterans, Guard and Reserves along with their
families."Serving those who serve us"
You need to have:
U.S. citizenship is required for this position due to U.S.
Department of Defense restrictions.
- High school diploma or equivalent
- 2 years of experience in customer service or related field
- Ability to learn medical and insurance terminology
We also prefer:
- Medical Insurance Experience
- Recent Military and Veterans Health claims processing with
knowledge of TRICARE benefits and guidelines, system applications,
medical terminology, and procedure codes
- After submitting your application, we will send you a customer
service online assessment if you have not already completed one. 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.
Compensation and Benefits
- Starting base salary $15.02 + shift differentials
- Eligible for annual Merit increases
- 401(k) withdollar-per-dollar match up to 6% of salary
- Competitive paid time off
- Health and dental insurance startDAY 1
- Vision insurance
- Flexible spending, dependent care, and health savings
- Short- and long-term disability, group life insurance
- Dress for your day
- Innovative professional and cognitive development programs
- Training Schedule:First 4 weeks, Monday- Friday, 8:00am- 4:35pm
(duration subject to change)
- Scheduled Shift: Different shifts available
- Work from Home: Remote potential is determined once training is
complete. Employee must be performing well in the position and able
to meet the at-home work requirements.
Who We Are
WPS Health Solutions is an innovator in health insurance and a
worldwide leader in claims administration, serving millions of
beneficiaries in the United States and abroad.
Founded in 1946, WPS offers health insurance plans for individuals,
families, and seniors, and group plans for small and large
businesses. We are a world-class claims processor and program
administrator for the government's Medicare program. And we manage
benefits for millions of active-duty and retired military personnel
and their families.
WPS has been named one of theWorld's Most Ethical Companies-- by
the Ethisphere-- Institute for 10 years in a row.
Learn more about WPS.
Our Purpose and Values
Our purpose is to make healthcare easier for those we serve.Click
Our values- Customer Focused, Individual Responsibility, Mutual
Respect, and Driven& Passionate- are the core of who we are and how
we conduct business every day.
WPS Health Insurance offers high-quality health insurance plans for
individuals and families, Medicare supplement plans for seniors,
and group health plans for businesses of every size.
Military and Veterans Health
WPS Military and Veterans Health administers claims and provides
customer service and related activities for the U.S. Department of
Defense and the U.S. Department of Veterans Affairs and their
Government Health Administrators
WPS Government Health Administrators manages Medicare Part A and
Part B benefits for more than 7 million beneficiaries. As one of
the largest contractors for the Centers for Medicare& Medicare
Services, we've served Medicare beneficiaries and their health care
providers since 1966.
Arise Health Plan provides innovative and high-value health plans
to groups and individuals in eastern and northeastern Wisconsin.
With our quality Wisconsin-based customer service, Arise offers
health care expertise with a personal touch.
EPIC Specialty Benefits
EPIC Specialty Benefits provides businesses group insurance
products that cover:
- Voluntary benefits
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Keywords: WPS Health Solutions, Madison , Customer Service Rep III , starting pay $15.02 + shift differentials, Sales , Madison, Wisconsin
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