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Company Name : Wisconsin Physicians Service Ins. Corp.
Location : Arizona
Position : Foreign Claims Processor $14.74/hr Start Date April 25th Remote position
Job Description : 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, along with being named one of Madison, Wisconsin’s Top Workplaces and recognized as one of the 2021 Achievers 50 Most Engaged Workplaces® Awards.
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.
Role Snapshot
Process 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.
In this role you will:
Process 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.
Translate, research, and verify claims information to determine if all requirements have been met.
Review submitted claim information and select correct procedure code and diagnosis code using ICD-9, ICD-10, CPT4, and HCPCS manuals.
Obtain development information from external contacts and add successful development information to notepad via PC.
Create and update all computer files for patient/sponsor screens, eligibility, and other health insurance information.
Coordinate translation of most frequently used foreign languages.
Convert foreign currencies to U.S. dollar amounts.
Update computer screens to payment levels for payable services.
Access patient/sponsor files and update information accordingly.
Correct claim information and adjudication errors through reprocess application.
Generate queries and re-queries from DEERS eligibility database, as well as data discrepancy records.
Determine medical review referral of claims based on contract requirements and diagnoses.
Use PC and on-line systems to research and obtain processing information.
How do I know this opportunity is right for me? If you:
Possess strong data entry skills with the ability to stay focused
Enjoy utilizing available resources to further research claims
Have excellent written communication skills
Are a self-driven, independent worker
What will I gain from this role?
Gaining experience with medical terminology and claims processing
Having a flexible schedule and working in a remote position
Being eligible for health insurance benefits from Day 1.
Experience working in an environment that serves our Nation’s military, veterans, Guard and Reserves and Medicare beneficiaries
Continuous performance feedback
Minimum Qualifications
High school diploma or equivalent
1 or more years in a position requiring personal computer and data entry skills
Ability to key a minimum of 40 words per minute
Ability to apply provider codes and specialties
Ability to learn medical terminology, diagnosis, and procedure codes
Ability to learn MVH regulations, policies, procedures, and on-line claims processing
procedures, system, and applications
Ability to learn provider coding, entry, OHI, and DEERS
Possess data entry and 10-key skills
S. citizenship is required for this position due to Department of Defense restrictions
COVID-19 vaccination or WPS approval for an accommodation
Preferred Qualifications
1 or more years in a claims processing role
Next steps:
After 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.
Additional Information:
Start Date: Monday, April 25, 2022
Starting Base Salary: starting at $14.74/hr
Training Schedule: 8:00am-4:35pm CST Monday-Friday (4 weeks)
Scheduled Shift: Flexible schedule once trained, 8-hours shifts between 6am-5pm
Work from Home: 100% remote, including training
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)
This post is listed Under Arizona jobs
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