[Remote] Medicare Customer Service Rep

Note: The job is a remote job and is open to candidates in USA. WPS, a health solutions company, is seeking a Medicare Customer Service Rep to provide responses to inquiries from medical providers related to Medicare topics. The role involves educating customers on coverage and claims submission while navigating multiple systems to resolve inquiries accurately and efficiently.ResponsibilitiesProvide responses to provider calls relating to Part A and/or Part B General Inquiries, Part A Appeals Status, Part B Reopening’s, and/or Part A and Part B Provider Enrollment InquiriesAssist and educate providers on Medicare regulations on inquiries by utilizing CMS guidelines, publications, and reference materials to ensure correct claim submissionEnroll providers with recurrent concerns or errors into contact programs for intensive educationMaintain 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,) and Customer Relations Management System (CRM)Work with internal and external customers to obtain information required to respond to and ensure consistency in the resolution of inquiry-related issuesAssist the department in meeting CMS performance and award fee metrics and all quality and quantity standardsSupport other departments within the division as needed, to ensure CMS performance requirements are maintainedEnsure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing information and can service to members and providersSkillsHigh School Diploma or GED or equivalent1 or more years of customer service experience working with health insurance and / or Medicare or Durable Medical Equipment ClaimsAbility to function in a fast paced, high volume call center environmentProficiency in Microsoft Office Suite and customer service softwareStrong verbal and written communication skills with the ability to effectively explain complex informationSolid ability to multitask, prioritize, and manage time effectively in a fast-paced environmentAbility to maintain a high level of accuracy and attention to detail1 or more years of Medicare customer service experience and/or claims processingSolid knowledge of Medicare Part A and/or Part B program guidelinesSolid knowledge of insurance, medical coding and medical terminologyBenefitsRemote work options availablePerformance bonus and/or merit increase opportunities401(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 offHealth insurance, dental insurance, and telehealth services start DAY 1Employee Resource GroupsProfessional and Leadership Development ProgramsCompany OverviewWPS, a health solutions company, is an independent, not-for-profit, local company based in Madison, Wisconsin. It was founded in 1946, and is headquartered in Madison, Wisconsin, USA, with a workforce of 1001-5000 employees. Its website is https://www.wpshealthsolutions.com/.



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