Who We Are
WPS Health Solutions 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 75 years. 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.
We are proud of the recognition we have received from local and national organizations regarding our culture and workplace.
Role Snapshot
The Cost Report Reopening Specialist reviews previously settled Medicare cost reports for errors and omissions. Upon locating an error, cost report reopening specialists revise to ensure proper payment for the Medicare provider.
In this role you will:
- Prepare detailed work papers to support audit adjustments to Medicare cost reports to ensure compliance with Government Auditing Standards. Verify Hospitals and other health care providers are not overpaid.
- Review and analyze complex financial statements and records. Secure PHI (Personal Health Information) and PII (Personal Identification Information).
- Utilize auditor judgment to determine the scope of review when reviewing Medicare cost reports.
- Provide written and verbal communication to hospitals and other health care providers.
- Review and communicate Medicare regulation and policy to hospitals and other health care providers.
- Provide written and verbal communication to Centers for Medicare and Medicaid Services (CMS) and other Government Agencies including Department of Justice (DOJ), General Accounting Office (GAO), Medicare management, and Provider Reimbursement Review Board (PRRB).
- Assist Cost Report Appeals Specialist in resolving appeals and obtaining Administrative Resolutions to avoid Appeal hearing procedures.
- Review, update, and initiate new procedures related to revising Medicare cost reports more accurately and efficiently.
How do I know this opportunity is right for me? If you:
- Thrive in a fast-paced environment that is deadline-driven.
- Are extremely detail-oriented and can identify inaccuracies easily.
- Feel comfortable defending your decisions with data and facts.
What will I gain from this role?
- Enjoying flexible work hours.
- Working remotely in the comfort of your home – no driving time, gas costs, or wear and tear on your vehicle.
- Working in an environment that serves our Nation’s military, veterans, Guard and Reserves along with their families. In addition, we also serve Medicare beneficiaries and providers.
Minimum Qualifications
- Accounting, Finance, Math, Business OR equivalent post high school education and/or work-related experience.
- Bachelor’s degree in Accounting or Finance.
Preferred Qualifications
- 1 year or more Accounting, Finance, Math, Business OR equivalent post high school education and/or work-related experience.
Salary Range
$52,000-$60,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.
Work Schedule
- Full-Time, Salaried
- Monday through Friday with start times flexible.
Work Location
We are a remote-first organization and offer remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin.
Benefits
- Remote work option available.
- Performance bonus and/or merit increase opportunities.
- 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately).
- Competitive paid time off.
- Health insurance, dental insurance, and telehealth services start DAY 1.
- Employee Resource Groups.
- Professional and Leadership Development Programs.
- Review additional benefits: ( https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml )
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
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