Billing and Enrollment Specialist

at WPS Health Solutions in Marion, Illinois, United States

Job Description

Billing and Enrollment Specialist
Who We Are
is a leading not-for-profit health insurer and federal government contractor headquartered in 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 Health Solutions has been making health care easier for the people we serve for more than . 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 inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse 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.
From 2021 to 2023, WPS Health Solutions was recognized for several awards:



Role Snapshot
Our Billing and Enrollment Specialist processes membership enrollment functions and assist in billing, cash posting, and ID card generation for new groups and members. Enter and maintain all group and membership data in our enrolment system, Facets. You will answer questions from members, groups, and providers relating to membership information. Ensure administrative requirements fulfill customer expectations.
How do I know this opportunity is right for me? If you:
Would enjoy answering written and phone inquiries from members, groups, and providers.
Enjoy researching and resolve eligibility discrepancies and errors, including an explanation to customers to address any discrepancies.
Can evaluate and determine eligibility of groups and members.
Can verify, enter, and maintain all group level and member level contract data for new business and update with any changes, including demographic, premium, benefit, and status information.
Want to ensure accuracy and adherence of coverage for certified availability of coverages.
Can process group cancellations and final accountings, perform collection of delinquent premium and termination for non-payment of premium.
Want to maintain awareness of underwriting guidelines, policy provisions, and product specifications as they pertain to customers.
Like communicating and Informing managers of issues that will require additional attention or procedure exceptions as needed to resolve a customer inquiry.
What will I gain from this role?
Being a key contributor on a team of other Billing and Enrollment Specialists in a highly complex highly regulated environment.
An in-depth understanding of state and federal regulations related to eligibility and enrollment, including COBRA, HIPAA.
Exposure with system configuration relating to billing, enrollment, ID card production, customer portals, and letter generation.
How to enter premium rate information for new groups and upon renewal, verify accuracy of billing statements, as well as assist with cash posting and billing reconciliation.
Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare
Working in a continuous performance feedback environment.
Minimum Qualifications
High School Diploma or equivalent.
1 year of related work experience.
Preferred Qualifications
One or more years in health insurance billing, enrollment, operations or data entry.
Experience working with WPS HI systems and processes.
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 )
Please review for additional information
Hourly Rate of Pay
$ 19.30 /hour ~ $21.00/ Hour
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside the posted range.
Start Date:
Work Schedule:
Core flex hour - Monday-Friday 8-hour days. Typically core... For full info follow application link.

Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.

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Job Posting: 11696134

Posted On: Feb 22, 2024

Updated On: Mar 02, 2024

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