[Hiring] Customer Service Representative @WPS—A health solutions company

Role Description

We are seeking talented Customer Service Reps / Customer Care Specialists to join our team! The successful candidate will play a critical role in providing call center telephone support, as well as responses to written inquiries submitted by military members, retirees, and dependents eligible for both TRICARE and Medicare benefits. In addition, this role is responsible for assisting with claims and billing inquiries from hospitals and clinics. Inquiries can include questions about claims, benefits, and eligibility. Success is accomplished by navigating multiple systems to research and resolve complex inquiries with a clear, accurate, and easy to understand response.

This is a Bargaining Unit / Union position.

Qualifications

• 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 (1717 W. Broadway in Madison, WI, 53713).
• High school diploma or equivalent.
• 2 or more years of experience in customer service (Call Center).
• Ability to learn medical and insurance terminology.

Requirements

• 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.

Benefits

• Bargaining Unit position
• 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 insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs