Customer Service Rep, Pay is $17.75/hr, 2nd Shift position - 10:25am - 7:00pm CS - (Must live within vicinity of Madison, WI WPS campus location)

Customer Service Reps / Customer Care Specialists

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.

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 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.

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.
• 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.

Preferred Qualifications

• 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.

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 )
• Please review Remote Worker FAQs for additional information

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
• Review additional benefits: ( )

Who We Are

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.

Culture Drives Our Success

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 workforceboth current and futureto 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.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.