Foreign Claims Processor Pay is 14.74/hr Start Date- April 25th Must be located within vicinity of Madison WI WPS campus

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 \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, along with being named one of \u003ca href=\u0022https://www.wpshealthsolutions.com/careers/index.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eMadison, Wisconsin\u0026rsquo;s Top Workplaces\u003c/a\u003e and recognized as one of the 2021 Achievers 50 Most Engaged Workplaces\u0026reg; Awards.\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.\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRole Snapshot \u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eProcess all MVH overseas claims from receipt through resolution in accordance with MVH regulations, guidelines, and quality standards, with expertise in coordination of benefits (COB), DEERS eligibility, and claims development.\u003c/p\u003e
\u003cp\u003eIn this role you will:\u003c/p\u003e
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\u003cli\u003eProcess all MH overseas claim types by determining corrective action to be taken on various types of errors pended by edit system and resolving interactive edits.\u003c/li\u003e
\u003cli\u003eTranslate, research, and verify claims 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\u003eObtain development information from external contacts and add successful development information to notepad via PC.\u003c/li\u003e
\u003cli\u003eCreate and update all computer files for patient/sponsor screens, eligibility, and other health insurance information.\u003c/li\u003e
\u003cli\u003eCoordinate translation of most frequently used foreign languages.\u003c/li\u003e
\u003cli\u003eConvert foreign currencies to U.S. dollar amounts.\u003c/li\u003e
\u003cli\u003eUpdate computer screens to payment levels for payable services.\u003c/li\u003e
\u003cli\u003eAccess patient/sponsor files and update information accordingly.\u003c/li\u003e
\u003cli\u003eCorrect claim information and adjudication errors through reprocess application.\u003c/li\u003e
\u003cli\u003eGenerate queries and re-queries from DEERS eligibility database, as well as data discrepancy records.\u003c/li\u003e
\u003cli\u003eDetermine medical review referral of claims based on contract requirements and diagnoses.\u003c/li\u003e
\u003cli\u003eUse PC and on-line systems to research and obtain processing information.\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\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ePossess strong data entry skills with the ability to stay focused\u003c/li\u003e
\u003cli\u003eEnjoy utilizing available resources to further research claims\u003c/li\u003e
\u003cli\u003eHave excellent written communication skills\u003c/li\u003e
\u003cli\u003eAre a self-driven, 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\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eGaining experience with medical terminology and claims processing\u003c/li\u003e
\u003cli\u003eHaving a flexible schedule and working in a remote position\u003c/li\u003e
\u003cli\u003eBeing eligible for health insurance benefits from Day 1.\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\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eHigh school diploma or equivalent\u003c/li\u003e
\u003cli\u003e1 or more years in a position requiring personal computer and data entry skills\u003c/li\u003e
\u003cli\u003eAbility to key a minimum of 40 words per minute\u003c/li\u003e
\u003cli\u003eAbility to apply provider codes and specialties\u003c/li\u003e
\u003cli\u003eAbility to learn medical terminology, diagnosis, and procedure codes\u003c/li\u003e
\u003cli\u003eAbility to learn MVH regulations, policies, procedures, and on-line claims processing\u003c/li\u003e
\u003cli\u003eprocedures, system, and applications\u003c/li\u003e
\u003cli\u003eAbility to learn provider coding, entry, OHI, and DEERS\u003c/li\u003e
\u003cli\u003ePossess data entry and 10-key skills\u003c/li\u003e
\u003cli\u003eUS. 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\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e1 or more years in a claims processing role\u003c/li\u003e
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\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\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\u003eAdditional Information:\u003c/strong\u003e\u003c/p\u003e
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\u003cli\u003e\u003cstrong\u003eStart Date:\u003c/strong\u003e Monday, April 25, 2022\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eStarting Base Salary\u003c/strong\u003e: $14.74/hr\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eTraining Schedule: \u003c/strong\u003e8:00am-4:35pm CST Monday-Friday (4 weeks)\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eScheduled Shift:\u003c/strong\u003e Flexible schedule once trained, 8-hours shifts between 6am-5pm\u003c/li\u003e
\u003cli\u003e\u003cstrong\u003eWork from Home:\u003c/strong\u003e Currently able to work from home, including training (not considered a permanent remote position). Must reside within area of Madison, WI WPS campus. This is a 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)\u003cstrong\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\u0026nbsp;\u003c/p\u003e
\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
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\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,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:2022-03-10T22:29:28.598Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2022-03-10T22:29:28.598Z,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