Apply on Employer Site

WPS—A health solutions company · 3 days ago

Customer Service Rep, Pay is $17.75/hr, (Must live within vicinity of Madison, WI WPS campus location)

Madison, WI

Full-time

Hybrid

Entry, Mid Level

$17.75/hr - $17.75/hr

2+ years exp

WPS is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. They are seeking a Customer Service Rep to provide call center support and assist military members and their dependents with inquiries related to TRICARE and Medicare benefits, claims, and billing issues.

GovernmentHealth CareHealth Insurance

No H1B

U.S. Citizen Only

Responsibilities

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 areas including external communication to obtain data

Complete research and provide final resolution to inquiries within contractual requirements

Communicate with inquirers 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 inquirers 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

Qualification

Customer serviceCall center experienceMedical terminologyMicrosoft OfficeMulti-taskingResearch skillsProblem-solvingCommunication skills

Required

U.S. citizenship is required for this position due to Department of Defense restrictions

Must live within the vicinity of our Madison, WI campus location (45 Miles from 1717 W. Broadway Madison, WI)

High school diploma or equivalent

2 or more years of experience in customer service (Call Center)

Ability to learn medical and insurance terminology

Preferred

Expertise in Microsoft Office (Outlook, Word, Excel), internet, intranet, office equipment, and data entry

Ability to navigate dual monitor screens and between multiple programs at once

Strong skillsets in multi-tasking, research, and problem-solving

Ability to work independently, deescalate situations with agitated individuals, control difficult situations, as well as influence and motivate others to comply with TRICARE procedures