customer service representative

data analyst

claims processor

utilization review nurse

customer care specialist

WPS Health Solutions

I am not saying this to slam the company.  They have the right to do what they need to do to win contracts.  But, the atmosphere is not for everyone!  In the training they make it seem fun and casual.  That is not the case!    If you retain information, and are a visual learner, then you will have a fighting chance.  This is my opinion, and I am offering it as I feel you are entitled to information before you leave another job for this one because it might pay more money.  I found out, the grass is not always greener on the other side.  Not everyone makes it through training, and quite a few once into this job opt to transfer to another department when a job becomes available, or quit, or are terminated.  They have implemented many changes, including updating their standards.  Some if not most will feel defeated and stressed out as they put you out on the floor answering phone calls immediately after training.  Training is a valuable asset that should set one up for success, and in that aspect they are definitely lacking.  At the back end of the training you sit with another employee and listen in on calls.  It would be great if they did that at the beginning if even for a few hours so you understood more of where what you are learning fell into place. You are not allowed to take home any materials to study on your own time, to become a better employee. On the job there is no time to chat or meet your new co-workers.  In order to cover the phone, they dictate exactly when each employee takes their breaks and lunches. You are not allowed to ask co-workers questions or for help.  There is no down time, you are busy 100% of your work day.  The standards are 100% productivity and 98% for quality.  People are not perfect, but they expect you to be.  You are expected to take a certain number of calls per hour.  Think about that.  You are receiving phone calls where the providers of service are asking you questions, yet you have to meet a quota as to the number of calls you are to answer, meaning the more calls you take, the better your score.  So on the other side of this is the less calls you take, the worse your score is.  That causes the CSR to have to find ways to give less information by not digging for the necessary information,  by then stressing out the provider of service causing them to call back again and hope they will get someone who will give them the info, and then the providers of service will say that it makes them not want to be part of our system to service our veterans.  That is sad and wrong!  Those who take the time to be good at helping the provider, therefore are taking too much time, therefore, are being reprimanded for it due to the standards.  For the quality of work they have another department listen to your phone calls and try to find any mistake you make, something you are not saying the way they want you to, in some cases a script.  The problem with that, is they get this information from a separate system.  You do have access to it, and it is mentioned in training, and in the handbook it has the first part of some of the items, but they never train you on it and there is a lot of it. You are expected to read it when the provider is waiting on the phone. That is how you learn it.  In taking this time, your productivity time will go down.  And, if you do want to look something up, it is difficult to find what you are looking for as they have different sections which have titles you would not know to look for, and some of the language in it is ambiguous.  And, it is that ambiguous language that the quality people use for those scores.  You will make mistakes, and you will learn from them as your quality standard goes down, and it can be very frustrating when it is something you were never trained on.  When you are pressured to meet productivity which is something that you do not have 100% control over as it involves interaction with the provider, and even with the accuracy, due to that interaction and how conversations can suddenly switch gears, then the accuracy can suffer.  When you try to be more accurate, which can slow you down, then the productivity will suffer.  They vigilantly monitor the 2 separate standards.  If they are not being met, then they put you under a plan where you are brought in and they monitor you every week, and there are steps for improvement, that when still not met, will lead to your termination.  This all adds more stress, which adds more chance for error, and for some it can be a cycle that eventually ends in someone being terminated or quitting.  Also, in between phone calls or at times when the amount of calls slow down, or the system is down, part of the productivity equation is processing corrected claims, keeping in mind, mid stream, the phone can ring.  And in addition to all of the above, they often make overtime mandatory.  If this is something you can handle, go for it.  But, If not, don't.

The best part is working with military retirees and working from home. I was hired (pre-pandemic) for a remote position. They provide the computer equipment, you provide a quiet workspace and high-speed internet. The training was decent, but it only gets you up to speed on navigating the various systems. The majority of the job is learned by YOU by doing the job and, therefore you learn quite a bit about healthcare, insurance, the claims process, Medicare, etc. It's an inbound call center and I speak with members and providers all day. There is call support for the reps, but when you reach out for help you are generally told to read the reference material and figure it out. And, some of the people that are supposed to provide help can be especially haughty. Many calls result in written work like sending a form, a claim rejection letter, a request for additional information, but you don't receive credit for those items toward your written work productivity. The only written work that counts is what the company receives and distributes out to be worked. All written items are worked between calls, there is no time off the phones. What matters most is quantity; the number of calls you take each day and the number of written items you complete, and the production metrics are pretty stiff. You are supposed to take so many phone calls per hour, but calls vary in length due to caller topic and complexity, so the quantity metrics are almost impossible to consistently achieve. Especially, if you have to research the caller's concern. You never go out of your way to give great customer service; just do the bare minimum of what the person called for to keep the call time as low as possible. It's basically a turn-and-burn culture, they use you up and get what they can out of you, constantly cracking the metrics whip. Not routinely making the quantity rankings will land you on a performance improvement plan and will eventually lead to dismissal. So, that in itself can be very stressful every day. And, there are always new hire training classes going on, so it doesn't really seem like it matters to management because there is always someone who will replace you. I can't say that I have ever felt particularly supported by my manager. If I hear something from my manager, I generally assume something is wrong; I don't trust that my manager would ever have my back. There is no coaching, continued training, or regular team meetings. There are, however, scathing emails sent to the team when there is a common issue. Being a healthcare insurance company, I thought the healthcare benefits would be great, but they're mediocre at best. The PTO is decent and you earn paid on-demand time as you go for any unplanned time off you may need (i.e., sick time, MDs appointments that come up, etc.). However, getting to use your PTO is a struggle. Toward the end of each quarter, you bid for your planned days off for the next quarter. Newer employees are not likely to get anything they ask for; it's all done by seniority. Once the quarter has begun you can pick through the leftover unrequested days and request days off within that quarter. So, it's not that you can't have time off, it's just that say if there's a family wedding coming up and you thought about taking the Thursday and Friday before to make it a long weekend for the trip, think again. For now, it's a job.

Don’t do it! It is a waste of your time.  I have held 2 prior jobs and one was for 10+ years and one was for 7+ years and I lasted 7 months here and it is not due to me or my work ethic.  Working from home is what appeals to you until the WPS system is down and you are expected to work hours around that issue with no consideration for your production.  Basically you have to work non stop with no errors and I mean no errors.  They do not care why you made a mistake.  You can rebuttal and try to get them to see why you interpreted the guideline how you did and they will literally make up an answer to keep your zero.  It is insane.  Oh but the guidelines are clear: no they aren’t and you cannot ask a question or discuss it so you can learn, you put your question on a spreadsheet and wait for a vague answer.  Why would the answer be vague?  Because the person who answered it started yesterday and they have no idea on what the question means or what the answer is.   Have you ever had a job that if you make a couple mistakes you are fired? Of course not, that is ridiculous.  And I mean a couple, like 2 mistakes.  I quit because the nonstop threatening of losing your job is too overwhelming for me personally.  I am motivated by money and growth, not fear of losing my job.  You may be reading this and thinking ‘I have never had a quality issue or production issue so I am not like this person, I will do fine’  I promise you, you won’t be fine.  You will get written up and pushed out the door.  It is the weirdest business model in the history of business.  They are mass hiring because their model does not work.  They do NOT care about keeping you and they will NOT do anything to help you grow.  You either get it right and process a lot of claims or you can leave.  That is the attitude of this company.   But they seem to be led by people who do not understand that this type of business model is not a good one.  I feel bad for our Veterans and the physicians that have contracts that WPS processes claims for because this business is cashing the check the VA is giving them and it is not going to a workforce that can plant roots and grow.  It is the worst company I have ever worked for.  My manager had no leadership experience and it was obvious.  There is not enough time to explain how bad the leadership is here.  I cannot speak to other roles or departments, maybe I just got ‘lucky’ applying for a claims processor and this may be how this department is ran only.  I don’t know.  If you have other options as far as a job offer, take it - even if the pay is lower because at least you will have a chance of keeping another job.  I have been in the work force for over 20 years and I have excelled at other jobs.  I have relocated from another state and unfortunately I have to start over in my career.  I am a self starter, quality focused, hard working, dedicated, smart, and I was written up for a 88% quality score and my production was over 100%.  I processed over 10,000 claims in 7 months so 88% quality seems like an OK score for someone with no medical claims experience and it isn’t for WPS.  Good luck to you!

IF YOU HAVE ANY ETHICS OR MORALS DO NOT WORK AT THIS COMPANY.  THEY ARE UNETHICAL, DISHONEST, NO MORALES, AND ARE BULLIES.  The supervisors that are there are THE WORST sups that I have ever seen.  They gather information about personal stuff they find out about the people they supervise and use it against them.  They lie about things that are happening and gets HR to back up the lies because they are buddy, buddy with HR.  The supervisors blame computer issues on the employees saying that the employees are not working hard enough.  They belittle and degrade the people they supervise in e-mails that they send to their unit.  WPS is supposedly an ethical company but they have no ethics whatsoever.  The hardest part of the job is always having to watch your back and to cover your butt against the supervisors.  The Management at WPS does not respect the employees.  They bully you if you have different views then they do or if you are smarter then they are.  I have learned always listen to the information that is posted about a company because 99% of the time it is all true.  They only promote BULLIES.  You have no chance of getting a better paying job in this company unless you are a bully.  THEY THINK BULLIES ARE THE GREATEST PEOPLE IN THE WORLD AND will promote them any chance they get.  This company cares nothing about the Veterans of this country.  They are only out to make money like any other insurance company.  They make up stupid reasons not to pay claims.  The pay, and the benefits are very low on the scale.  There is nothing positive about working for this company.
 If the management does not like you, YOU WILL BE FIRED.  75% OF THE WORK STAFF WILL BE FIRED OR FORCE TO RESIGN IN THE NEXT 60 DAYS.  The claims processors have to work off of spreadsheets and having to do that production requirement cannot be met.  The training that we receive is very poor or all departments.  They give you 4 hours of training (it should be 4 weeks of training) in the pricing role which is a very hard role to work and expect you to meet the standards immediately.  The OLLI instructions are confusing even the person that wrote them could not figure out what she was talking about when she gave the training.
  DO NOT APPLY TO WORK FOR THIS COMPANY.  THEY DISRESPECT ALL THE VETERANS.  THEY ARE UNETHICAL, ABUSIVE, NO MORALS, THEY THINK THEY ARE NOT RESPONSIBLE FOR THEIR ACTIONS.  THEY MAKE FUN OF THE DEPARTMENT OF DEFENSE (calling them uneducated idiots). do not work for this company you will regret it!!!!!!!

I did not enjoy working here.  In the contract that I worked, there is way too much mandatory overtime.  You can work as many hours as you want, but you are usually required to do a minimum number of mandatory overtime hours.  We are constantly behind because of how much work there is, so beneficiaries and health care providers call and complain constantly about how long things are taking.  And then of course a claim gets messed up pretty often so they need to be reprocessed and meanwhile the provider keeps calling every few days wondering where their payment is. 

Management seems to be pretty lax.  I felt like I could get away with underperforming and my job would have been secure.  The only thing they really seemed to care about is that you were there and taking calls.  People who sat around me would be so rude to the caller and were never disciplined.  If you're a warm body who can answer the phone and pass a really stringent background check they will hire you.  

The benefits were severely misrepresented when they made me an offer.  They sent me this sheet that says that 1-5 get 'X' days of vacation, but they didn't say what it would be starting out, so the assumption is that is what it starts at..  It turned out to be 1/4 of the number of paid days as the sheet indicated.  

So I was working 50 hours a week at a really stressful job and couldn't really take any days off.  It's amusing that they wonder why turnover is terrible.

The training program is long and drawn out because they need you to get interim security clearance before you can work independently.  But the training program dwells on unnecessary content and doesn't really prepare you to be on your own.  I feel like my training was a waste of 5 weeks of my life, but at least they pay for it!  After you get your interim clearance they put you on the phone immediately whether you feel ready or not, and then they put you into corrections.  Basically, that means that when you are audited they check you work for accuracy, before you can do things like reprocess claims.  But if you keep making mistakes you could be on corrections for a very long time and keep delaying things even further for the beneficiary.

The wages aren't very competitive, but I thought the insurance was decent.  I had a couple of coworkers that I liked, which was nice.  It's hard to get to know your team because you're each expected to be on the phone for 8-10 hours a day.

Because turnover is pretty bad I feel like if I was willing to keep doing the job for more than a year or so I could have easily gotten a promotion or transition into a different department.

WPS was once a workplace that had values. The environment has changed in the last 2 years it has become a hiring / firing chain, there really is no reason to stay long.  The management is short-sighted and does not care about the staff.   The company goals are met through games of shifting work into roles.  The performance of staff is based on quantity - quality is not valued, even though it is measured to some degree,  often quality is not caught when staff are just pushing claims through.   A claim processed incorrectly will consume resources but WPS has no measurements for the reworking, so the focus is on high numbers in quantity. 
I have heard of long-term employees who up and left in recents months, also many were terminated under performance metrics that are not only inaccurate but also in reality unobtainable if the staff do what is required.  The systems have times when they are down daily, and employees must work around downtime, some of which is somewhat predicatble however most is not at the same exact times so it is hard to plan around it.  Essentially employees work off the clock because they have to make up for the system down-time. 
This is a totally unprofessional workplace.  The suspervisors and management for the most part are  not only lacking in qualifications but are so focussed on their ladder-climbing that it sets an example of a toxic work environment all around.   Emails from Management, Supervisors, Unit Coordintaors have spelling errors,  grammatical errors and incomplete sentences.   Often the persons typing the emails know nothing about what they are speaking to.  The procedures are written so haphazardly that they are unclear.  The work instructions were improving and then it went downhill.  
Employees suffer from hgih levels of stress and uncertainty.  The productivity / quality standards are unreasonable  The audits are done haphazardly and are suspect as they seem to be done when an employee is put on a performance improvement plan more than otherwise.   The majority of staff are on performance improvements plans, this is also an example of how toxic the work environment has become. 
This is not a place to learn business ethics or skills.  If you must take a job here, you will suffer at some point.  Be prepared to have health issues.  The stress creates all sorts of problems and even affects employee home life negatively,

Employes are treated and told they are disposable.   Continuous threats of being written up for performance.   The majority of employees have been written up, many have left on their own accord.   It is almost like a joke as WPS is constantly hiring ... say 20 or more every month or two, however probably only 5 if lucky will still be employed at WPS in 6 months.   It is a very strange set of goals the management has setup.  The high quantity expectations encourages sloppy work and if it is not audited it doesn't hurt so that is how some decide to work.   Many people have become stressed out and burned out.   As employees are terminated, MANDATORY overtime is common, they call it scheduled overtime now, but it is the same as mandatory.  This is an example of the disrespect the employees face.   Employees are told that hours are flexible, however not so much when the systems are down a few hours daily.  Employees are expected to work around when the system is down or slow as it would impact their performance (number of claims processed).   The system issues have increased dramatically in the last 6 months.    Another joke is how many claims have to be touched a half dozen times, usually for simply issues because the quality is so low.  

If you have a choice between WPS and another employer, make sure you realize even if  you make the numbers at some point they do expect more, the bar is constantly being raised.   Also, there is no accomodations for system issues or claims issues, you MUST meet numbers.   

There are very few employees left that have more than a year of service.   However, the executive keep saying how the company is growing... growing into what?   

There were many good employees at this company.   The lack of employee morale.  The toxic work environment has led to employees all competing with each other which in the end is not good for the long term of the company.   

The guidelines that employees are expected to use to process claims are not understood at all by the supervisors or even the department that has ownership of the guidelines.   The only role of supervisors is to "coach" employees.   There is no support.   The training is minimal and done by people who never did the processing.   

Run  RUN RUN from thsi place... save your soul...

Ive been at WPS for less than a year. The company presents itself as conscious of employee and customer happiness for the sake of happiness rather than increased profit, which I was skeptical of. Having been here for a while I have gotten the impression from my own management and above that they do actually take employee and customer engagement and happiness seriously beyond the motivation of simply making more money. Because of that it’s a fairly nice place to work as management is flexible with work hours/structure and is very supporting of professional development opportunities. That said I sometimes get the impression from the top that they are more money focused but they seem to be trying to balance profit with happiness at least (obviously a business needs to make profit to survive).

A major perk of WPS is the ability to work from home, which is pretty common in the company (something like 1/3 of people before COVID). Personally that is a bigger perk than other health-insurance/time-off/401k-matching benefits although those are also fairly good (19 days off w/ 10 more holidays and 6% 401K match is pretty good). I cant speak to wage-increases much but I have had the impression that they can be limited yearly and are almost always only a few percent increases, which is unfortunate. They do have a yearly bonus system which provides a certain percent of your salary which depends on your own performance and overall company performance. The downside of a yearly bonus system is it can limit more spontaneous bonuses for successful project completion.

Overall I have a positive impression of the company and am happy working here. The benefits are good, the pay is pretty good, and the work culture is very positive. I have good engagement and support from my own manager and his superior. There are a lot of people who have worked here for a long time so they must be doing something right.

I worked in the call center for the MVH. The best part of the job was when you got to talk to the veterans and help answer their questions about benefits and their claims. The absolute worst part was dealing with third party billers which were foreigners calling from India. They were extremely hard to understand, their English was horrible. You had to constantly repeat yourself and they would call numerous times about the same person/issue. Some of them were downright rude and nasty and we had to put up with these idiots who I sometimes wondered how they could get up in the morning and get dressed because they were so stupid. They were required to use the IVR but then never did because it was too much work and management did nothing to enforce that. The pay is horrible, you get a 2%  raise each year which is a slap in the face. The insurance is good and you get a decent amount of vacation but unfortunately you can't take your vacation when you want, only the senior employees get it when they want. They are constantly short staff. And forget taking 1 day off, you won't get it. Also, if you ask for more than 1 week, they might give you a few of the day and deny the other ones so if you have a trip planned forget it, you would be able to go.  The IVR was horrible, we would get constant complaints from the providers and veterans on how frustrating it was to use. I mentioned something to my boss's boss and he said to talk to my boss, he didn't want to listen or talk to me about it. The calls are back to back, you get 3 seconds in between calls to put your notes in which is not enough time so you have to go into after call work. There are emails that go out constantly telling people to take calls because their would be calls holding and certain people would abuse the after call work button.

In the beginning (a week ago) I was an excited new hire for WPS looking forward to the possibilities a new job would have. If I had any indication a week later I would be forced out of my job due to retaliation from management and a hostile work environment that followed after I would have spent the time I was wasting waiting for the training class to start to look for a job that actually has a healthy and positive work culture. on the second day of training We had a town hall style meeting with the President/CEO of the company the. the man himself while during the meeting called himself an a** this was later blown to a scale when i later brought it back up that they were accusing me of having called him an a** which not one of my fellow peers heard but wasn't brought to my attention until 4pm the next day AFTER on the second I had gotten into a difference of opinion debate with a one of the trainers in the early morning. I was then being unfairly scrutinized down to the darn right petty. They penalized me for literally being 1 Minute and yes i literally mean 1 Minute late. they even yelled at me on my last day for rolling my eyes saying that kind of body language goes against there core values. The last time i was yelled at for rolling my eyes was back in the 4th grade.The staff there are so immature and child like they cant handle differences in a opinions and throw temper tantrums when you do. Children don't even get upset over an eye roll that didn't even have anything to do with anyone other then the person i was actually talking to. They honestly do not care about the individual person you are a grunt they know they have power over you and they will exploit it ever chance they possible could.

Top Job Titles	Average Salary
Customer service representative 6 salaries reported	$19.03 per hour
Data analyst 2 salaries reported	$23.00 per hour
Claims processor 2 salaries reported	$18.68 per hour
Utilization review nurse 4 salaries reported	$70,875 per year
Customer care specialist 1 salary reported	$17.20 per hour

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