Senior Analyst - Reimbursement

Senior Analyst - Reimbursement

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.

From 2021 - 2023 WPS Health Solutions has been recognized for several awards including:

• Madison, Wisconsin's Top Workplaces
• USA Top Workplaces and the 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
• DAV Patriot Employer
• VETS Indexes 4 Star Employer

Role Snapshot

You will provide guidance and expertise to Reimbursement Analysts in determining provider settlement amounts by performing reviews of accounts receivable and payable work activity, on the job training and work direction to contribute to the efficient administration of the Medicare program.

In this role you will:

• Work with several areas, including Payment Recovery, Financial Reporting, and Audit.
• Provide training, guidance, work direction, and expertise to Reimbursement Analysts.
• Review accounts receivable and payable work activities ensuring compliance with Medicare regulations and contract quality performance requirements.
• Verify entry of payable and receivable data on appropriate financial system and identify discrepancies for correction.
• Provide subject matter expertise to assist with classroom presentations and to participate in workgroups.
• Perform provider overpayment reconciliation process to ensure accurate and timely account balances are reflected in monthly reconciliations.
• Analyze delinquent provider overpayment accounts for potential referral to Department of Treasury and record delinquent accounts in appropriate database.
• Verify accuracy of interest assessments charged on delinquent accounts.
• Coordinate processing of levies, IRS liens, civil monetary penalties, and state agency withholdings to ensure overpayments made to providers by other government organizations are collected from provider Medicare payments.
• Compile and analyze data for special projects and initiatives directed by CMS, Department of Justice, General Accounting Office, or Medicare management.
• Perform a review of Medicaid Analysis to determine whether overpayment is eligible for Medicaid offset.
• Fulfill requests for CMS regarding bankruptcy-filings and provider inquiries.

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

• Have a strong attention to detail and accuracy
• Have a strong sense of urgency and the ability to prioritize your workload
• Have strong interpersonal skills with an excellent communication, customer service, and a "can do" mentality
• Have the ability to work independently and as part of a team
• Are process oriented, proactive and able to identify opportunities for efficiency

What will I gain from this role?

• Gaining exposure to what it is like to work for a government contractor in a corporate insurance environment
• 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

• High School Diploma or equivalent
• One (1) or more years of experience with progressive responsibility in bookkeeping/accounting

Preferred Qualifications

• Associate degree in Accounting, Business, or related field OR equivalent post high school education and/or work-related experience
• Minimum 2 years of experience with Microsoft Office
• Thorough knowledge and understanding of Medicare regulations and accounting procedures related to accounts payable and receivable and collection activities

Hourly Rate of Pay

• Accounts Payable - Accounts Receivable Support 3
  • Starting hourly rate: between $21/hour to $26.00/hour based on county SCA rates.

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: (GHA: Omaha, Nebraska)

Remote Worker Requirements

For 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)

Benefits

• Remote and hybrid work options 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)