Customer Service Representative II

Profile

\u003cp\u003e\u003cstrong\u003eRole Summary:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eAnswer inquiries from beneficiaries, providers, and other affiliated representatives or groups regarding TRICARE eligibility, benefit determinations, and claims adjudication questions or problems.\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eIn this role you will:\u003c/strong\u003e\u003c/p\u003e
\u003cul\u003e
\u003cli\u003eReceive telephone, written, fax, and e-mail inquiries concerning TRICARE eligibility, benefits determinations, and claims adjudication questions or billing problems.\u003c/li\u003e
\u003cli\u003eApply appropriate provisions of TRICARE regulations, interpretations, and procedural directives in making determinations on eligibility and benefits to determine appropriate responses to inquiries.\u003c/li\u003e
\u003cli\u003eObtain and analyze claims data to determine specific problem area including external communication to obtain data.\u003c/li\u003e
\u003cli\u003eComplete research and provide final resolution to inquiries within contractual requirements.\u003c/li\u003e
\u003cli\u003eCommunicate with inquirer to determine appropriate authorization or referral of services.\u003c/li\u003e
\u003cli\u003eSubmit claims for adjudication, correction, payment, or review as appropriate.\u003c/li\u003e
\u003cli\u003eEducate providers on billing requirements of TRICARE to reduce claim problems.\u003c/li\u003e
\u003cli\u003eDeal tactfully with people in a wide variety of situations to convey a favorable corporate image.\u003c/li\u003e
\u003cli\u003eRespond to inquirer using various forms of communication (written letter, telephone, web, or email) within time frames to exceed contractual standards.\u003c/li\u003e
\u003cli\u003eCollect and record data for Customer Service records and computer analysis.\u003c/li\u003e
\u003cli\u003eInform supervisory staff of system problems when identified, researching problems to provide backup data and examples when needed.\u003c/li\u003e
\u003c/ul\u003e
\u003cp\u003e\u003cstrong\u003eThis role could be a good fit if you: \u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eEnjoy conversing with customers over the phone\u003c/li\u003e
\u003cli\u003eHave the ability to learn medical and insurance terminology\u003c/li\u003e
\u003cli\u003eThrive in a fast paced work environment\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eYou\u0026rsquo;ll benefit from this experience by:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eGaining experience working in a call center environment\u003c/li\u003e
\u003c/ul\u003e
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\u003cli\u003eWorking in an environment that serves our Nation\u0026rsquo;s military, veterans, Guard and Reserves along with their families.\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eYou need to have: \u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e\u003cstrong\u003eU.S. citizenship is required for this position due to Department of Defense restrictions.\u003c/strong\u003e\u003c/li\u003e
\u003cli\u003eHigh school diploma or equivalent\u003c/li\u003e
\u003c/ul\u003e
\u003cp\u003e\u003cstrong\u003eWe also prefer:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e2 or more years of experience in customer service or claims for the VA contract within WPS\u003c/li\u003e
\u003cli\u003eAbility to learn medical and insurance terminology\u003c/li\u003e
\u003cli\u003eMicrosoft Office Experience\u003c/li\u003e
\u003cli\u003eAbility to navigate dual monitor screens\u003c/li\u003e
\u003cli\u003eRecent Military and Veterans Health claims processing with knowledge of TRICARE benefits and guidelines, system applications, medical terminology, and procedure codes\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eNext steps:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eAfter submitting your application, we will send you an online assessment. 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.\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eAdditional Information:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e\u003cstrong\u003eStart Date:\u003c/strong\u003e Monday, October 11\u003csup\u003eth\u003c/sup\u003e, 2021\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eTraining Schedule: \u003c/strong\u003eFirst 4-5 weeks, 8:00am-4:35pm CST Monday-Friday\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eScheduled Shift:\u003c/strong\u003e Shift Bids, Shift Starting between 7:00am-9:30am CST Monday-Friday\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eWork from Home:\u003c/strong\u003e This is a 100% remote opportunity for all approved remote worker states. This is a non-exempt, non-bargaining unit position\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eCompensation and Benefits\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eEligible for annual Performance Bonus Program\u003c/li\u003e
\u003cli\u003e401(k) with \u003cstrong\u003edollar-per-dollar match up to 6% of salary\u003c/strong\u003e\u003c/li\u003e
\u003cli\u003eCompetitive paid time off\u003c/li\u003e
\u003cli\u003eHealth and dental insurance start \u003cstrong\u003eDAY 1\u003c/strong\u003e\u003c/li\u003e
\u003cli\u003eVision insurance\u003c/li\u003e
\u003cli\u003eFlexible spending, dependent care, and health savings accounts\u003c/li\u003e
\u003cli\u003eShort- and long-term disability, group life insurance\u003c/li\u003e
\u003cli\u003eDress for your day\u003c/li\u003e
\u003cli\u003eInnovative professional and cognitive development programs\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eWho We Are\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS 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.\u003c/p\u003e
\u003cp\u003eFounded 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\u0026rsquo;s Medicare program. And we manage benefits for millions of active-duty and retired military personnel and their families.\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022http://wpshealthsolutions.com/about/index.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eLearn more about WPS\u003c/strong\u003e\u003c/a\u003e\u003cstrong\u003e. \u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eOur Purpose and Values\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eOur purpose is to make healthcare easier for those we serve. \u003ca href=\u0022http://www.wpshealthsolutions.com/about/purpose-values.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eClick Here\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003eOur values \u0026ndash; Customer Focused, Individual Responsibility, Mutual Respect, and Driven \u0026amp; Passionate \u0026ndash; are the core of who we are and how we conduct business every day.\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eWPS Health Insurance\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS 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.\u003c/p\u003e
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\u003cp\u003e\u003cstrong\u003eMilitary and Veterans Health\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS 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 beneficiaries.\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022http://wpshealthsolutions.com/business-units/wpsmvh.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003ehttp://wpshealthsolutions.com/business-units/wpsmvh.shtml\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eGovernment Health Administrators \u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS 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 \u0026amp; Medicare Services, we\u0026rsquo;ve served Medicare beneficiaries and their health care providers since 1966.\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022http://wpshealthsolutions.com/business-units/wpsgha.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003ehttp://wpshealthsolutions.com/business-units/wpsgha.shtml\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eWPS Health Plan\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS Health Plan offers Health Maintenance Organization and Point-of-Service plans to the group and individual markets in eastern and north-central Wisconsin, plus third-party administrator services.\u003c/p\u003e
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\u003cp\u003e\u003cstrong\u003eEPIC Specialty Benefits\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eEPIC Specialty Benefits provides businesses group insurance products that cover:\u003c/p\u003e
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\u003cli\u003eLife\u003c/li\u003e
\u003cli\u003eDisability\u003c/li\u003e
\u003cli\u003eDental\u003c/li\u003e
\u003cli\u003eVision\u003c/li\u003e
\u003cli\u003eVoluntary benefits\u003c/li\u003e
\u003c/ul\u003e
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\u003cp\u003e\u003cstrong\u003eStay connected:\u0026nbsp;\u003c/strong\u003e\u003ca href=\u0022http://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/Account/Register?cancelUrl=https://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/?q=WPS&o=relevance\u0026amp;redirectUrl=/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/JobSearchAgent\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eSign up for Job Alerts\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eFOLLOW US!\u003c/strong\u003e\u003c/p\u003e
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\u003cp\u003e\u003cstrong\u003e\u003ca href=\u0022https://www.linkedin.com/company/wps-health-solutions/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eLinkedIn\u003c/a\u003e\u003c/strong\u003e\u003c/p\u003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement:The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:false,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:cdefa8ae-f907-5c13-2775-f0106d0aa34a,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2021-08-31T19:44:20.231Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2021-08-31T19:44:20.231Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null,CompensationAnnualMinimum:null,CompensationAnnualMaximum:null,CompensationHourlyMinimum:null,CompensationHourlyMaximum:null,CompensationCurrency:null});

Company info

Wisconsin Physicians Service Insurance Corporation
Website : http://www.wpsic.com