JOB REQUIREMENTS: Description Customer Care Specialist, Pay is\$17.00/hr, Start Date- February 12th (Must live within vicinity ofMadison, WI campus location) Who We Are is a leading not-for-profithealth insurer in Wisconsin. Our services offer health insurance plansfor individuals, families, seniors, and group plans for small to largebusinesses. We process claims and provide customer service support forbeneficiaries of the Medicare program and manage benefits for millionsof active-duty and retired military personnel across the U.S. andabroad. In 2021, WPS Health Solutions celebrates of making healthinsurance easier for those we serve. Proud to be military and veteranready. Our Culture WPS\' Performance-Based Culture is where the greatwork and innovations of our people are seen, fueled, and rewarded. Weaccomplish this by creating an inclusive, empowering employeeexperience, focusing on People, Work, and Conditions. This results inpeople bringing their authentic selves to work every day in anorganization that successfully adapts to business changes and newopportunities. We are guided by our Purpose: Together, making healthcare easier for the people we serve. In 2021 & 2022, WPS HealthSolutions was recognized for several awards including: Role SnapshotAnswer inquiries from beneficiaries, providers, and other affiliatedrepresentatives or groups regarding TRICARE eligibility, benefitdeterminations, and claims adjudication questions or problems. In thisrole you will: Receive telephone, written, fax, and e-mail inquiriesconcerning TRICARE eligibility, benefits determinations, and claimsadjudication questions or billing problems. Apply appropriate provisionsof TRICARE regulations, interpretations, and procedural directives inmaking determinations on eligibility and benefits to determineappropriate responses to inquiries. Obtain and analyze claims data todetermine specific problem area including external communication toobtain data. Complete research and provide final resolution to inquirieswithin contractual requirements. Communicate with inquirer to determineappropriate authorization or referral of services. Submit claims foradjudication, correction, payment, or review as appropriate. Educateproviders on billing requirements of TRICARE to reduce claim problems.Deal tactfully with people in a wide variety of situations to convey afavorable corporate image. Respond to inquirer using various forms ofcommunication (written letter, telephone, web, or email) within timeframes to exceed contractual standards. Collect and record data forCustomer Service records and computer analysis. Inform supervisory staffof system problems when identified, researching problems to providebackup data and examples when needed. How do I know... For full infofollow application link. Wisconsin Physicians Service InsuranceCorporation is an Equal Opportunity Employer/ProtectedVeterans/Individuals with Disabilities employer. ***** APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/10A26FF1DEE34CAE Qualified females,minorities, and special disabled veterans and other veterans areencouraged to apply.