Employer Service Representative

Job overview

The Employer Service Representative role is onsite in Wheeling, WV, with listed work hours of 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m., totaling 40 hours. Compensation is not specified. The Health Plan of West Virginia’s Customer Service Department handles complex and escalated inquiries from internal and external customers. The representative researches and resolves issues involving claims, network relations, benefits, eligibility, and member experience. The role supports accurate, timely service by communicating with members, providers, clients, brokers, and internal teams while protecting confidential health information.

What you'll do

• Answer calls and written correspondence
• obtain information from clients, members, and providers to resolve issues
• research claim-processing errors and process network settlements and pre-service agreements
• coordinate with claims and customer service teams
• record and track information accurately
• explain benefits and eligibility
• identify claim issues and escalate them when needed
• protect member PHI.

What we're looking for

Skills & competencies

employer service representative

customer service

health insurance

claims support

benefits and eligibility

member services

wheeling wv

the health plan of west virginia

40 hours

8:00 am–4:30 pm

8:30 am–5:00 pm

phi confidentiality

Work arrangement

• Weekend coverage required

Why this role

The posting lists two possible schedules: 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m.; 40 hours per week.

About the employer

The Health Plan of West Virginia Inc is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.