Claims Representative-Remote position Pay 14/hr Start date April 25th

Profile

\u003cp\u003e\u003cstrong\u003eWho We Are\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022https://www.wpshealthsolutions.com/about/index.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eWPS Health Solutions\u003c/a\u003e is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small to large businesses. We process claims and provide customer service 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. In 2021, WPS Health Solutions celebrated\u0026nbsp;\u003ca href=\u0022https://www.wpshealthsolutions.com/75/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e75 years\u003c/a\u003e of making health insurance easier for those we serve.\u0026nbsp; Proud to be military and veteran ready.\u0026nbsp;\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eOur Culture\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS\u0026rsquo; Performance-Based Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive, empowering employee experience, focusing on People, Work, and Conditions. 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 guided by our Purpose: Together, making health care easier for the people we serve.\u0026nbsp;\u003c/p\u003e
\u003cp\u003eIn 2021, WPS Health Solutions was recognized for several awards including:\u003c/p\u003e
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\u003cli\u003e\u003ca href=\u0022https://www.wpshealthsolutions.com/careers/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eMadison, Wisconsin\u0026rsquo;s Top Workplaces \u003c/a\u003e\u003c/li\u003e
\u003cli\u003e\u003ca href=\u0022https://topworkplaces.com/october-2021-awards-reveal/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eTop Workplace national cultural excellence awards for Remote Work and Work-Life Flexibility\u003c/a\u003e\u003c/li\u003e
\u003cli\u003e\u003ca href=\u0022https://www.wpshealthsolutions.com/careers/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eAchievers 50 Most Engaged Workplaces\u0026reg; with the further honor of Achievers \u0026ldquo;Elite 8\u0026rdquo; winner in the category of Culture Alignment \u003c/a\u003e\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRole Snapshot \u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eProcess all Military and Veterans Health (MVH) claims from receipt through resolution in accordance with MVH regulations, guidelines, and quality standards, with expertise in coordination of benefits (COB), eligibility, and claims development.\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eIn this role you will:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eAnalyze claims to determine if eligibility requirements and claim filing requirements are met and make determinations.\u003c/li\u003e
\u003cli\u003eCalculate multiple Other Health Insurance (OHI) COB amounts using data from claims, such as the EOB or prior payment information given. Identify when to pend to other departments based on guidelines.\u003c/li\u003e
\u003cli\u003eProcess all claim types by determining corrective action to be taken on various types of errors pended by system and resolving interactive edits.\u003c/li\u003e
\u003cli\u003eProcess beneficiary-submitted claims.\u003c/li\u003e
\u003cli\u003eProcess the highest priority claims from Customer Service.\u003c/li\u003e
\u003cli\u003eTranslate, research, and verify claim information to determine if all requirements have been met.\u003c/li\u003e
\u003cli\u003eReview submitted claim information and select correct procedure code and diagnosis code using ICD-9, ICD-10, CPT4, and HCPCS manuals.\u003c/li\u003e
\u003cli\u003eDeal tactfully with people in a wide variety of situations to convey a favorable corporate image.\u003c/li\u003e
\u003cli\u003eAdjudicate specialty claims, including, but not limited to, pharmacy, ambulatory surgery, skilled nursing, dental, anesthesia, medical assistance, reprocessed claims, duplicate claims, ambulance, durable medical equipment (DME), or institutional based charges.\u003c/li\u003e
\u003cli\u003eWrite letters to providers and beneficiaries for missing claim information to process claim through\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eHow do I know this opportunity is right for me?\u0026nbsp; If you: \u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eAre able to multi-task and navigate between multiple screens\u003c/li\u003e
\u003cli\u003eHave an analytical mindset along with good reading comprehension and computer knowledge\u003c/li\u003e
\u003cli\u003eEnjoy working independently in a fast-paced environment\u003c/li\u003e
\u003cli\u003eEmbrace variety in work functions\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eWhat will I gain from this role?\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eGaining experience with medical terminology and claims processing\u003c/li\u003e
\u003cli\u003eWorking in a remote position with a flexible schedule\u003c/li\u003e
\u003cli\u003eExperience working in an environment that serves our Nation\u0026rsquo;s military, veterans, Guard and Reserves and Medicare beneficiaries\u003c/li\u003e
\u003cli\u003eContinuous performance feedback\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eMinimum Qualifications \u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eHigh school diploma or equivalent\u003c/li\u003e
\u003cli\u003eU.S. citizenship is required for this position due to Department of Defense restrictions\u003c/li\u003e
\u003cli\u003eCOVID-19 vaccination or WPS approval for an accommodation\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003ePreferred Qualifications \u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e1 or more years of experience processing claims in a healthcare or insurance environment\u003c/li\u003e
\u003cli\u003eAbility to navigate dual monitors\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eAdditional Information:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e\u003cstrong\u003eStart Date:\u003c/strong\u003e Monday, April 25\u003csup\u003eth\u003c/sup\u003e, 2022\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eStart Pay:\u003c/strong\u003e $14/hr\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eTraining Schedule: \u003c/strong\u003eFirst 4 weeks, Monday- Friday 8:00-4:35pm CST\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eScheduled Shift:\u003c/strong\u003e Monday- Friday between the hours of 6:00am and 10:00pm (CST). Must work 8 hours minimum per day.\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eWork from Home: \u003c/strong\u003e100% Remote opportunity for all approved remote worker states. This is a non-exempt, non-bargaining unit position.\u003c/li\u003e
\u003cli\u003eFor remote position, employee is required to meet remote worker requirements, including a designated work station, a wired (Ethernet) connection to the network, and a minimum of 10Mbps downstream connection with at least 1Mbps upstream (can be checked at https://speedtest.net)\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eNext steps:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e\u003cstrong\u003e\u003cem\u003eAfter submitting your application, we will send you an online assessment. We recommend you complete it within 1-2 business days. You must complete and obtain a passing score on the assessment to be considered for the position. \u003c/em\u003e\u003c/strong\u003e\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003eBenefits\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eRemote and hybrid work options available\u003c/li\u003e
\u003cli\u003ePerformance bonus and/or merit increase opportunities\u003c/li\u003e
\u003cli\u003e401(k) with \u003cstrong\u003edollar-per-dollar match up to 6% of salary \u003c/strong\u003e(100% vested immediately)\u003c/li\u003e
\u003cli\u003eCompetitive paid time off\u003c/li\u003e
\u003cli\u003eHealth, dental insurance, Teladoc starts \u003cstrong\u003eDAY 1\u003c/strong\u003e\u003c/li\u003e
\u003cli\u003eReview additional benefits \u003ca href=\u0022https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003ehere\u003c/a\u003e\u003c/li\u003e
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\u003cp\u003e\u003ca href=\u0022http://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/Account/Register?cancelUrl=https://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/?q=WPS&o=relevance\u0026amp;redirectUrl=/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/JobSearchAgent\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eSign up for \u003c/strong\u003e\u003cstrong\u003eJob Alerts\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eFOLLOW US!\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u003ca href=\u0022https://www.linkedin.com/company/wps-health-solutions/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eLinkedIn\u003c/a\u003e\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u003ca href=\u0022https://www.facebook.com/WPSHealthSolutions/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eFacebook\u003c/a\u003e\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u003ca href=\u0022https://twitter.com/WPS_HS\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eTwitter\u003c/a\u003e\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement: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),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:false,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:cdefa8ae-f907-5c13-2775-f0106d0aa34a,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2022-03-15T13:47:56.81Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2022-03-15T13:47:56.81Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null,CompensationAnnualMinimum:null,CompensationAnnualMaximum:null,CompensationHourlyMinimum:null,CompensationHourlyMaximum:null,CompensationCurrency:null});

Company info

Wisconsin Physicians Service Insurance Corporation
Website : http://www.wpsic.com