Medicare Customer Service Rep

Our Medicare Customer Service Rep plays a critical role in providing responses to telephone inquiries from medical providers or representatives related to a wide range of Medicare topics involving Part A (hospital insurance) and/or Part B (medical insurance). They are accountable for educating customers on coverage, claim submission, and use of self‑service offerings. Success is achieved by navigating multiple systems to research and resolve inquiries with a clear, accurate, and easy‑to‑understand response.

Preference will be given to those with Medicare and call‑center experience.

• Start Date:
  
  8/25/26
• Starting hourly rate: $19.60/hour (may vary based on county SCA rates)
• Training Location/
  
  Schedule:
  
  Mandatory Training – first 5 weeks, Monday–Friday from 7:30 AM to 4:05 PM CST
• Scheduled Shift: After training – shifts can start as early as 6:55 AM or as late as 8:30 AM CST and are 8 hours, based on business need
• Work from Home: 100% remote opportunity within approved remote worker states

Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

• Provide responses to provider calls relating to Part A and/or Part B general inquiries, Part A appeals status, Part B reopenings, and/or Part A and Part B provider enrollment inquiries.
• Assist and educate providers on Medicare regulations using CMS guidelines, publications, and reference materials to ensure correct claim submission.
• Enroll providers with recurrent concerns or errors into contact programs for intensive education.
• Maintain knowledge of A and/or B processing systems and applications required for job functions, including MCSDT, FISS, CWF, SNAP, PECOS, OnBase, MAS, and CRM.
• Work with internal and external customers to obtain information required to respond to and ensure consistency in the resolution of inquiry‑related issues.
• Assist the department in meeting CMS performance and award‑fee metrics and all quality and quantity standards.
• Support other departments within the division as needed to ensure CMS performance requirements are maintained.
• Ensure adherence to regulatory guidelines (HIPAA, CMS) when providing information and servicing members and providers.

• High School Diploma or GED or equivalent.
• 1 or more years of customer service experience working with health insurance and/or Medicare.
• Ability to function in a fast‑paced, high‑volume call‑center environment.
• Proficiency in Microsoft Office Suite and customer service software.
• Strong verbal and written communication skills with the ability to explain complex information effectively.
• Solid ability to multitask, prioritize, and manage time effectively in a fast‑paced environment.
• Ability to maintain a high level of accuracy and attention to detail.

• 1 or more years of Medicare customer service experience and/or claims processing.
• Solid knowledge of Medicare Part A and/or Part B program guidelines.
• Solid knowledge of insurance, medical coding, and medical terminology.

• Wired (ethernet cable) internet connection from router to 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.

• 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 starting DAY 1.
• Employee Resource Groups.
• Professional and Leadership Development Programs.
• Review additional benefits:

This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.