Medicare Systems Coordinator

Profile

\u003ch3 style=\u0022text-align: center;\u0022\u003e\u003cstrong\u003eMedicare Systems Coordinator\u003c/strong\u003e\u003c/h3\u003e
\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 celebrates \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\u003eCoordinate and perform maintenance and testing as required by policy changes, Shared System Maintainer mandates, or Centers for Medicare and Medicaid Services (CMS) directives within specified timeframes. This includes updating and maintaining system files to report and test issues. Research and provide written responses to internal and external customer inquiries or system issues pertaining to Shared System or files.\u003cbr /\u003e\u003cbr /\u003e\u003cstrong\u003eIn this role, you will:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003eComplete Centers for Medicare and Medicaid Services (CMS) Change Requests to implement required changes/enhancements. Includes requesting/validating maintenance, performing\u003c/li\u003e
\u003cli\u003emaintenance, System Control Facility coding, testing, validation of testing/coding, annual profile build, and assuring system accuracy. Maintain documentation.\u003c/li\u003e
\u003cli\u003eDownload, verify, and install Centers for Medicare and Medicaid Services update files as directed.\u003c/li\u003e
\u003cli\u003ePrepare Maintenance Request forms and perform manual system maintenance to load files and updates that cannot be systematically installed. Provide Fee Schedule Disclosures and\u003c/li\u003e
\u003cli\u003epricing articles. Review, analyze, and provide contractor feedback.\u003c/li\u003e
\u003cli\u003eReview, analyze, and test a variety of applications on mainframe and Personal Computer base. Maintain Healthcare Integrated General Ledger Accounting System. Write, test, and cross copy ECPS events for Claims Processing. Conduct CEM and IVR patch testing.\u003c/li\u003e
\u003cli\u003eRetain, review, compile and submit information needed for support of litigations.\u003c/li\u003e
\u003cli\u003eProvide technical expertise in interpretation of issues relating to Medicare regulations and claims processing.\u003c/li\u003e
\u003cli\u003ePerform testing for Fraud Prevention Service before release testing goes into system.\u003c/li\u003e
\u003cli\u003ePrepare and issue notices to inform, educate, or alert operations and customer service areas when systems issues have been identified.\u003c/li\u003e
\u003cli\u003eDevelop excel based worksheets to assist in manual pricing calculations and verification of CMS pricing files.\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\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\u003eHave Medicare Part A claims processing experience\u003c/li\u003e
\u003cli\u003eHave worked with the FISS systems\u003c/li\u003e
\u003cli\u003eHave an analytical mindset\u003c/li\u003e
\u003cli\u003ePossess excellent communication and reading comprehension skillsets\u003c/li\u003e
\u003cli\u003eAre a self-motivated independent worker\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\u003eExpanding your skillset in a higher level claims role\u003c/li\u003e
\u003cli\u003eBeing a part of a supportive and collaborative team while also working independently\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\u003e1 or more years of related work experience to include Part A claims processing and/or Customer Service experience.\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\u003eExperience with MCS and/or FISS systems\u003c/li\u003e
\u003cli\u003eExperience with Part A Claims or Appeal processing\u003c/li\u003e
\u003cli\u003eKnowledge/billing of hospital-based claims using the direct data entry system\u003c/li\u003e
\u003cli\u003eCustomer Service role that also includes escalated, or priority experience with Part A and the FISS system\u003c/li\u003e
\u003cli\u003eMAC contractor experience working with the FISS system\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,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:2021-12-22T15:32:14.134Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2021-12-22T15:32:14.134Z,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