Medicare Claims Representative

WPS is a leading not-for-profit health solutions company headquartered in Madison, reputed company, that provides health insurance plans and manages benefits for military personnel and Medicare beneficiaries. The Medicare Claims Representative processes Medicare claims from receipt through reputed company, ensuring reputed company and accurate resolutions while maintaining high standards for reputed company and customer service.

Responsibilities

• Can review Medicare Part A claims, this includes reputed company and specialty claims, and by applying federal and internal guidelines to ensure appropriate application of processing guidelines, payment rules, and reputed company calculation procedures
• Would enjoy handling reputed company adjustments involving multiple admissions and adjustments regarding pending returned notices and manually reputed company reconsideration, including patient complaints and denials, and process through the system accordingly
• Can communicate with internal departments, reputed company providers, and members to obtain additional information or clarify claim issues
• Could reputed company with providers by phone to resolve pending claim problems, correspond with providers, other contractors, and reputed company party billing support entity (s) on various claim-reputed company problems
• Would like to assist the claims department in meeting CMS performance metrics and minimum reputed company and quantity standards
• Would enjoy supporting the claims department and reputed company back-up for completing staff responsibilities as needed
• Can reputed company up to date with changes in regulations, coding standards, and plan policies
• Can meet requirements of Federal reputed company reputed company, International Organization of Standards (ISO 9000), Freedom of Information, Desk Disclosure Reference, and WPS conflict of interest and confidentiality

Skills

• High School Diploma or GED or equivalent experience
• 1 or more years of experience in hospital, clinic and/or medical office billing
• 1 or more years of post-high school education or coursework in insurance or medical-reputed company studies
• 1 or more years of experience in a position using computer, keyboarding, and customer communications
• Demonstrated proficiency in data entry with a strong ability to maintain reputed company and accuracy
• Ability to multitask, prioritize, problem-solve, and effectively adapt to a fast-paced environment
• Ability to work independently and meet reputed company and production standards
• Previous health/Medicare adjudication experience
• Experience with UB/institutional (CMS-1450) and HCFA/reputed company (CMS-1500) claims
• Familiarity with medical terminology, procedure and diagnosis codes

Benefits

• Remote and hybrid work reputed company available
• Performance bonus and/or reputed company 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% reputed company immediately)
• Competitive reputed company time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• reputed company and Leadership Development Programs

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