WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, 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 has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready. WPS’ culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique 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.
Medicare Customer Service Rep
Location
United States
Posted
6 days ago
Salary
$20 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Medicare Customer Service Rep
WPS—A health solutions company
Role Description Our Medicare Customer Service Rep plays a critical role in providing responses to telephone inquiries from medical providers or representatives related to a wide range of Medicare topics involving Part A (hospital insurance) and/or Part B (medical insurance). They are accountable to educate customers on coverage, claim submission, and use of self-service offerings. Success is accomplished by navigating multiple systems to research and resolve inquiries with a clear, accurate, and easy to understand response. Preference will be given to those that have Medicare and call center experience. Qualifications - High School Diploma or GED or equivalent. - 1 or more years of customer service experience working with health insurance and/or Medicare. - Ability to function in a fast-paced, high-volume call center environment. - Proficiency in Microsoft Office Suite and customer service software. - Strong verbal and written communication skills with the ability to effectively explain complex information. - 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. Requirements - Can provide responses to provider (and other third-party contacts) calls relating to: - Part A and/or Part B General Inquiries - Part A Appeals Status - Part B Reopenings - Part A and Part B Provider Enrollment Inquiries - Would enjoy assisting and educating providers on Medicare regulations on inquiries by utilizing CMS guidelines, publications, and reference materials to ensure correct claim submission. - Can enroll providers with recurrent concerns or errors into contact programs for intensive education. - Would like to maintain knowledge of A and/or B processing systems and applications required for job functions, including: - Multi-Carrier System Desktop (MCSDT) - Fiscal Intermediary Shared System (FISS) - Common Working File (CWF) - CMS Secure Net Access Portal (SNAP) - Provider Enrollment Chain and Ownership System (PECOS) - OnBase - Medicare Appeals System (MAS) - Customer Relations Management System (CRM) - Like to work with internal and external customers to obtain information required to respond to and ensure consistency in the resolution of inquiry-related issues. - Can assist the department in meeting CMS performance and award fee metrics and all quality and quantity standards. - Would enjoy supporting other departments within the division as needed, to ensure CMS performance requirements are maintained. - Want to ensure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing information and can service to members and providers. Preferred Qualifications - 1 or more years of Medicare customer service experience and/or claims processing. - Solid knowledge of Medicare Part A and/or Part B program guidelines. - Solid knowledge of insurance, medical coding, and medical terminology. 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 speedtest.net ). Benefits - Remote work options available. - Performance bonus and/or merit increase opportunities. - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your 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.
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