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WPS Health Solutions: Cost Report Reopening Specialist (Absecon)

WPS Health Solutions

This is a Contract position in Absecon, NJ posted October 12, 2020.

Role Summary:The Cost Report Reopening Specialist reviews previously settled Medicare cost reports for errors and omissions. Upon locating an error, cost report reopening specialists revise to ensure proper payment for the Medicare provider.In this role you will:Prepare detailed work papers to support audit adjustments to Medicare cost reports to ensure compliance with Government Auditing Standards. Verify Hospitals and other health care providers are not overpaid.Review and analyze complex financial statements and records. Secure PHI (Personal Health Information) and PII (Personal Identification Information).Utilize auditor judgment to determine scope of review when reviewing Medicare cost reports.Provide written and verbal communication to hospitals and other health care providers.Review and communicate Medicare regulation and policy to hospitals and other health care providers.Provide written and verbal communication to Centers for Medicare and Medicaid Services (CMS) and other Government Agencies including Department of Justice (DOJ), GeneralAccounting Office (GAO), Medicare management, and Provider Reimbursement Review Board (PRRB).Assist Cost Report Appeals Specialist in resolving appeals and obtaining Administrative Resolutions to avoid Appeal hearing proceduresReview, update, and initiate new procedures related to revising Medicare cost reports more accurately and efficiently.This role could be a good fit if you:Thrive in a fast-paced environment that is deadline driven.Are extremely detailed oriented and can identify inaccuracies easily.Feel comfortable defending your decisions with data and facts.You ll benefit from this experience by:Enjoying flexible work hours.Working remotely in the comfort of your home no driving time, gas costs, or wear and tear on your vehicle.Working in an environment that serves our Nation s military, veterans, Guard and Reserves along with their families. In addition, we also serve Medicare beneficiaries and providers.You need to have:Bachelor s degree in Accounting, Finance, Math, Business OR equivalent post high school education and/or work-related experience18 months or more in Medicare Audit and Reimbursement role with progressive responsibilityCompensation and BenefitsEligible for annual Performance Bonus Program401(k) withdollar-per-dollar match up to 6% of salaryCompetitive paid time offHealth and dental insurance startDAY 1Vision insuranceFlexible spending, dependent care, and health savings accountsShort and long-term disability, group life insuranceDress for your dayInnovative professional and cognitive development programsWho We AreWPS Health Solutions is an innovator in health insurance and a worldwide leader in claims administration, serving millions of beneficiaries in the United States and abroad.Founded in 1946, WPS offers health insurance plans for individuals, families, and seniors, and group plans for small and large businesses. We are a world-class claims processor and program administrator for the government s Medicare program. And we manage benefits for millions of active-duty and retired military personnel and their families.WPS has been named one of theWorld’s Most Ethical Companies by the Ethisphere Institute for 10 years in a row.Learn more about WPS.Our Purpose and ValuesOur purpose is to make healthcare easier for those we serve.Click HereOur values Customer Focused, Individual Responsibility, Mutual Respect, and Driven& Passionate are the core of who we are and how we conduct business every day.Health InsuranceWPS Health Insurance offers high-quality health insurance plans for individuals and families, Medicare supplement plans for seniors, and group health plans for businesses of every size. and Veterans HealthWPS Military and Veterans Health administers claims and provides customer service and related activities for the U.S. Department of Defense and the U.S. Department of Veterans Affairs and their beneficiaries. Health AdministratorsWPS Government Health Administrators manages Medicare Part A and Part B benefits for more than 7 million beneficiaries. As one of the largest contractors for the Centers for Medicare& Medicare Services, we ve served Medicare beneficiaries and their health care providers since 1966. Health Plan provides innovative and high-value health plans to groups and individuals in eastern and northeastern Wisconsin. With our quality Wisconsin-based customer service, Arise offers health care expertise with a personal touch. Specialty BenefitsEPIC Specialty Benefits provides businesses group insurance products that cover:LifeDisabilityDentalVisionVoluntary benefits connected: Sign-up for Job AlertsFOLLOW US!FacebookTwitterLinkedInAssociated topics: antibody, cytometry, dietary, disease, healthcare, nutrition, nutritionist, pharmaceutical, physiologist, vaccine