Provider Enrollment Analyst / Credentialing, fully

at WPS Health Solutions in Marion, Illinois, United States

Job Description

Provider Enrollment Analyst / Credentialing, Fully Remote - Start Date July 29th
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, 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
Role Snapshot
The Provider Enrollment Analyst will approve, deny, or return applications submitted by Medicare providers. This work is important in helping providers enroll in the Medicare program.
In this role you will:
Utilize on-line Medicare files/systems to verify research, update, and document enrollment information
Respond to provider/customer enrollment telephone and written inquiries
Ensure all provider enrollment data is properly controlled and tracked to ensure applications are approved or denied within standards of timeliness established by department and Centers for Medicare and Medicaid Services (CMS)
Enter data into on-line national database and internal provider files (PECOS)
Research and verify proper fees and inspections have been completed on certain suppliers
How do I know this opportunity is right for me? If you:
Possess confidence in your skills navigating a computer to process applications efficiently through multiple operating systems
Prioritize effectively, stay on task, and work independently
Are comfortable critically examining, analyzing and reviewing work items in detail for accuracy
Possess strong communication skills, both verbal and written
Enjoy research and problem-solving
What will I gain from this role?
Helping our providers enroll in Medicare to support the senior community
Having the opportunity to earn more by being a top performer
Enjoying flexible work hours
Opportunity to work remotely in the comfort of your home - no driving time, gas costs, or wear and tear on your vehicle
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 of business experience, including working in the insurance industry, claims processing, health care credentialing, billing or medical reimbursement.
Preferred Qualifications
Associates degree in business administration, insurance, healthcare, or related fields
2 or more years of business experience, including working in the insurance industry, claims processing, health care credentialing, billing or medical reimbursement.
Experience interpreting government regulations and applying to current processes.
Course work in insurance, medical, customer service and/or financial
1 or more years of computer and navigation experience; preferably working with dual monitors
Good work ethic and good attendance
Ability to communicate effectively over the phone
Experience working in a production-based environment
Additional Information:
Start Date: Monday, July 29th, 2024
Starting Base Pay: $20.50 per hour
Training Schedule: (5-6Weeks): Monday through Friday, 8:00-4:35pm CST
Scheduled Shift: Monday through Friday, 6:00am-6:00pm, Flex Scheduling, max of 10 hours per day and 40 hours minimum per week
Work Location: This position is 100% remote. 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: Omaha, NE
Remote Worker Requirements: For remote position, employee is required to meet remote worker requirements, including a designated workstation, a wired (Ethernet)... For full info follow application link.

Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.

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Job Posting: 11977416

Posted On: Jun 14, 2024

Updated On: Jun 22, 2024

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