Payment Specialist - REMOTE

Who We Are

WPS Health Solutions 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 75 years of making health insurance easier for those we serve. Proud to be military and veteran ready.

Our Culture

WPS' 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.

In 2021 and 2022, WPS Health Solutions was recognized for several awards including:

• Madison, Wisconsin's Top Workplaces
• Top Workplace national cultural excellence awards for Remote Work and Work-Life Flexibility
• Achievers 50 Most Engaged Workplaces® with the further honor of Achievers "Elite 8" winner in the category of Culture Alignment
• Disabled American Veteran Patriot Employer

Role Snapshot

The Payment Specialist will assist providers, who support our military and their families, with calculating special payments in ordinance with Tricare Contracts. This includes working with providers to calculate payments for their initial and amended cases, researching the status of previous payments, and developing a letter to accompany the payment after it is made.

• Answer inquiries concerning Capital and Direct Medical Education (Cap DME) reimbursement.
• Obtain and analyze claims data to complete research and provide final resolution to inquiries within contractual requirements.
• Submit requests for adjudication, correction, payment or review.
• Process requests for CAP DME reimbursement.
• Assist providers with billing requirements.
• Provide timely responses to inquiries using various forms of communication.
• Inform supervisory staff of system problems when identified, researching problems to provide backup data and examples when needed.

How do I know this opportunity is right for me? If you:

• Are a strong communicator that provides great customer service with excellent email etiquette to respond to provider inquires.
• You have excellent attention to detail to ensure payments are calculated correctly. This includes auditing high dollar cases and researching previous payments for our providers.
• You enjoy a deadline driven team environment in which you can show case your time management skills to support our providers from the beginning to the end of the payment process.
• Are process improvement-minded and see to find ways to streamline or automate processes.

What will I gain from this role?

• Working on a truly collaborative team who is willing to help you be successful.
• An open environment where your opinions and feedback matter.
• Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries.
• Working in a continuous performance feedback environment.

Minimum Qualifications

• U.S. citizenship is required for this position due to Department of Defense restrictions
• High School Diploma or Equivalent

Preferred Qualifications

• Payment processing or Accounting/Finance experience
• MS Excel - intermediate knowledge
• Demonstrated experience in showing:
  
  • Attention to Detail
  • Working with tight deadlines
  • Strong writing skills in terms of professionalism, tone, grammar, spelling, punctuation.
  • Strong professional verbal communication
  • Team collaboration
  • Curiosity and the ability to identify process improvements

Hourly Rate of Pay

Between $16.00/hr to $22.00/hr based on county SCA rates.

Work Hours

Monday through Friday with work hours between 7:00 AM and 7:00 PM (CST). Daily 8-hour shifts with split schedule options. Overtime as needed. Shifts to start no later than 9:00 AM (CST).

Work Location

This role is open to remote work for this opportunity in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin

To help strengthen communication, provide a sense of community, and improve the overall remote work experience, the assigned office community based on the position's division is West Frankfort, Illinois.

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, dental insurance, Teladoc starts DAY 1
• Review additional benefits here

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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)