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WPS Health Solutions

Billing & Enrollment Specialist

Posted 6 Days Ago
In-Office or Remote
17 Locations
20-20 Hourly
Junior
In-Office or Remote
17 Locations
20-20 Hourly
Junior
The Billing and Enrollment Specialist processes membership enrollments, assists in billing, cash posting, and generates ID cards, ensuring compliance and addressing inquiries from members and stakeholders.
The summary above was generated by AI

Our Billing and Enrollment Specialist processes membership enrollment functions and assists in billing, cash posting, and ID card generation for new groups and members within our Health Plan. They enter and maintain all group and membership data in our enrollment system. This Billing and Enrollment Specialist provides support and answers questions or inquiries received from members, agents, and group leaders, relating to membership information to ensure administrative requirements are fulfilled and customer expectations are met.
Hourly Rate of Pay: $ 19.76 /hour
The base pay offered for this position may vary from the posted range based on your job-related knowledge, skills, and experience.

Work Schedule:
Core flex hour - Monday-Friday 8-hour days. Typically core hours are between 7:30am-5:00pm Central.

Work Location:
We are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

 How do I know this opportunity is right for me?  If you:

  • Enjoy responding to written and phone inquiries from members, agents, and group leaders.
  • Can verify, enter, and maintain all group level and member level contract data for new business including updating changes to demographic, premium, benefit, and status information.
  • Like to maintain awareness of underwriting guidelines, policy provisions, and product specifications as they pertain to customers.
  • Can ensure accuracy and adherence of coverage for certified availability of coverages.
  • Have processed group cancellations and conduct final accounting reviews.
  • Could perform collections of delinquent premium and termination for non-payment of premium.
  • Like to research and resolve eligibility discrepancies and errors; provide an explanation to customers to address the discrepancy or error.
  • Can communicate and inform managers of issues that will require additional attention or procedure exceptions as needed to resolve a customer inquiry.

Minimum Qualifications

  • High School Diploma, GED or equivalent
  • 2 or more years of experience in health plan operations, enrollment, billing, or related healthcare field.
  • Proficient in billing and enrollment processes and procedures.
  • Excellent verbal and written communication and interpersonal skills.
  • Ability to work independently, be self-motivated and maintain positive relationships with customers and colleagues.
  • Strong organizational and problem-solving skills with proven attention to detail.

 Preferred Qualifications

  • Ability to learn contract provisions regarding eligibility and termination.
  • Ability to learn and apply FACETS applications related to billing and enrollment.
  • Ability to accurately enter data.
  • Knowledge of eligibility and termination contract provisions.
  • Knowledge of state and federal eligibility and enrollment regulations.
  • Proficient knowledge of Microsoft Excel.

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 https://speedtest.net)
  • Please review Remote Worker FAQs for additional information

Benefits

  • Remote work options available
  • Performance bonus and/or merit increase opportunities
  • 401(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 off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  •  Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

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 workforce—both current and future—to 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.

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Top Skills

Facets Applications
Excel

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