Talent.com
Medicare File Coordinator
Medicare File CoordinatorWPS Health Solutions • Indianapolis, IN, United States
Medicare File Coordinator

Medicare File Coordinator

WPS Health Solutions • Indianapolis, IN, United States
11 hours ago
Job type
  • Full-time
Job description

Description

Role Snapshot

Our Medicare File Coordinator coordinates and performs maintenance and testing as required by policy changes, Shared System Maintainer mandates, or Centers for Medicare and Medicaid Services (CMS) directives within specified timeframes. This includes updating and maintaining system files to report and test issues. Research and provide written responses to internal and external customer inquiries or system issues pertaining to Shared System or files. Researches and responds to interdepartmental referrals, reviews and updates processes and coding guidelines for accuracy and effectiveness.

Salary Range

$44,000-53,700 annually

The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills and experience.

We are open to remote work in the following approved states :

Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

In this role, you will :

  • Complete Centers for Medicare and Medicaid Services (CMS) Change Requests to implement required changes / enhancements.

Requesting, validating maintenance, performing maintenance, System Control Facility coding, testing, validation of testing / coding, annual profile build, and assuring system accuracy.

  • Maintain documentation.
  • Download, verify, and install Centers for Medicare and Medicaid Services update files as directed.
  • Write, test, and cross copy ECPS events for Claims Processing.
  • Maintain Healthcare Integrated General Ledger Accounting System.
  • Conduct CEM and IVR patch testing.
  • Validate changes in the Direct Data Entry System.
  • Prepare Maintenance Request forms and perform manual system maintenance to load files and updates that cannot be systematically installed.
  • Provide Fee Schedule Disclosures and pricing articles.
  • Review, analyze, and provide contractor feedback.
  • Review, analyze, and test a variety of applications on mainframe and Personal Computer base.
  • Retain, review, compile and submit information needed for support of litigations.
  • Provide technical expertise in interpretation of issues relating to Medicare regulations and claims processing.
  • Prepare and issue notices to inform, educate, or alert operations and customer service areas when systems issues have been identified.
  • Develop excel based worksheets to assist in manual pricing calculations and verification of CMS pricing files.
  • Perform processing guideline updates and / or request coding changes for the Targeted Probe and Educate (TPE) audits as needed.
  • Develop skills to request maintenance to update internal coding and processing guidelines for MCS and FISS.
  • Attend and actively participate in weekly Functional Workgroup (FWG) Calls for MCS and FISS to develop skills collaborating with other MACs and CMS.
  • Review Quarterly MCS Screen Manual changes made by MCS, analyze the changes affecting the processing departments and perform the corresponding updates to the internal manual.
  • What will I gain from this role?

  • Expanding your skillset in a higher-level specialized claims role.
  • Being a part of a supportive and collaborative team while also working independently.
  • Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries.
  • Work in a continuous performance feedback environment.
  • Minimum Qualifications

  • Bachelor's Degree in related field or equivalent post high school and / OR related work experience.
  • 1 or more years of experience in Medicare, Medical Review, Claims, Appeals, OR Customer Service in a healthcare environment.
  • Possess excellent reading comprehension, written communication, and interpersonal skillsets.
  • Ability to utilize sound reasoning and analysis for creative problem-solving, as well as ability to overcome regular distractions to meet strict deadlines.
  • Proficiency in Microsoft Office Suite and / OR HART, OnBase, FISS and MCS systems.
  • Experience with Part A and Part B Claims or Appeal processing.
  • Preferred Qualifications

  • Experience with SecureZip, Cute PDF, Adobe Reader, Center for Medicare & Medicaid internal Applications, SnagIt, internet, intranet, office equipment.
  • Knowledge / billing of hospital-based claims using the direct data entry system.
  • Customer Service experience this role includes escalated, or priority experience with Part A and Part B FISS and MCS systems.
  • MAC contractor experience working with the FISS and MCS systems.
  • Remote Work Requirements

  • Wired (ethernet cable) internet connection from your router to your computer
  • High speed cable or fiber internet
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at )
  • Please review Remote Worker FAQs for additional information
  • Benefits

  • Remote and hybrid work options available
  • Performance bonus and / or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary ( 100% vested immediately )
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits : ()
  • Who We Are

    WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer 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. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

    Culture Drives Our Success

    WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. 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 proud of the recognition we have received from local and national organization regarding our culture and workplace : WPS Newsroom - Awards and Recognition.

    Sign up for Job Alerts

    FOLLOW US!

    Instagram

    LinkedIn

    Facebook

    WPS Health Blog

    This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and / or sensitive data to safeguard government resources that provide critical services.

    Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

    This employer is required to notify all applicants of their rights pursuant to federal employment laws.

    For further information, please review the Know Your Rights notice from the Department of Labor.

    Create a job alert for this search

    File Coordinator • Indianapolis, IN, United States

    Related jobs
    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    LRS Healthcare • Carmel, IN, US
    Full-time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...Show more
    Last updated: 18 days ago • Promoted
    Lead Grants Coordinator

    Lead Grants Coordinator

    American Red Cross • Indianapolis, IN, United States
    Full-time
    Please use Google Chrome or Mozilla Firefox when accessing Candidate Home.By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spi...Show more
    Last updated: 8 hours ago • Promoted • New!
    Sr Medical Writer - Medical Device + Regulatory Documents - Remote Based

    Sr Medical Writer - Medical Device + Regulatory Documents - Remote Based

    Syneos Health / inVentiv Health Commercial LLC • Indianapolis, IN, United States
    Remote
    Full-time
    Sr Medical Writer - Medical Device + Regulatory Documents - Remote Based.Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success.We...Show more
    Last updated: 13 days ago • Promoted
    Travel CT Technologist - $2,344 per week

    Travel CT Technologist - $2,344 per week

    Source Medical Staffing • Carmel, IN, United States
    Full-time
    Source Medical Staffing is seeking a travel CT Technologist for a travel job in Carmel, Indiana.Job Description & Requirements. Source Medical Staffing Job ID #57748321.Pay package is based on 8 hou...Show more
    Last updated: 30+ days ago • Promoted
    Travel Multimodal Technologist - $2,439 per week

    Travel Multimodal Technologist - $2,439 per week

    GLC On-The-Go • Fishers, IN, United States
    Full-time
    GLC On-The-Go is seeking a travel Multimodal Technologist for a travel job in Fishers, Indiana.Job Description & Requirements. Pay package is based on 8 hour shifts and 40 hours per week (subject to...Show more
    Last updated: 22 days ago • Promoted
    Travel Labor and Delivery RN - $1,983 per week

    Travel Labor and Delivery RN - $1,983 per week

    Ardor Health Solutions • Fishers, IN, United States
    Full-time
    Ardor Health Solutions is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fishers, Indiana.Job Description & Requirements. Ardor Health Solutions is looking for a Labor and ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Labor and Delivery RN - $1,849 per week

    Travel Labor and Delivery RN - $1,849 per week

    Anders Group • Fishers, IN, United States
    Full-time
    Anders Group is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fishers, Indiana.Job Description & Requirements. Pay package is based on 12 hour shifts and 36 hours per week...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $178 per week in Columbus, IN

    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $178 per week in Columbus, IN

    TravelNurseSource • Columbus, IN, US
    Full-time +1
    TravelNurseSource is working with Lancesoft Inc to find a qualified ICU / Critical Care RN in Columbus, Indiana, 47201!.We are currently seeking qualified candidates for RN.Shift Custom Shift Night, ...Show more
    Last updated: 30+ days ago • Promoted
    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    AlliedTravelNetwork • Carmel, IN, US
    Full-time
    AlliedTravelNetwork is working with LRS Healthcare to find a qualified CT Tech in Carmel, Indiana, 46032!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 2...Show more
    Last updated: 18 days ago • Promoted
    Travel Labor and Delivery RN - $1,986 per week

    Travel Labor and Delivery RN - $1,986 per week

    Voca Healthcare • Fishers, IN, United States
    Full-time
    Voca Healthcare is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fishers, Indiana.Job Description & Requirements. Benefits available on 1st of the month after start : .Voca ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Labor and Delivery RN - $2,609 per week

    Travel Labor and Delivery RN - $2,609 per week

    Coast Medical Service • Carmel, IN, United States
    Full-time
    Coast Medical Service is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Carmel, Indiana.Job Description & Requirements. Coast Medical Service is a nationwide travel nursing...Show more
    Last updated: 30+ days ago • Promoted
    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    Travel CT Tech - $1,968 to $2,182 per week in Carmel, IN

    AlliedTravelCareers • Carmel, IN, US
    Full-time
    AlliedTravelCareers is working with LRS Healthcare to find a qualified CT Tech in Carmel, Indiana, 46032!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 2...Show more
    Last updated: 30+ days ago • Promoted
    Solutions Implementation Specialist / Project Coordinator - UC

    Solutions Implementation Specialist / Project Coordinator - UC

    Konica Minolta Business Solutions • Columbus, IN, United States
    Full-time
    The Solution Implementation Specialist (SIS) will provide management of concurrent projects from inception through successful implementation. This role is the sole point of contact for customers and...Show more
    Last updated: 18 days ago • Promoted
    Travel CT Technologist - $2,486 per week

    Travel CT Technologist - $2,486 per week

    Malone Healthcare - Nursing • Carmel, IN, United States
    Full-time
    Malone Healthcare - Nursing is seeking a travel CT Technologist for a travel job in Carmel, Indiana.Job Description & Requirements. Shift & Schedule Primary Schedule : Thursday : 8 : 00a – 4 : 30p Frid...Show more
    Last updated: 7 days ago • Promoted
    Travel Labor and Delivery RN - $1,773 per week

    Travel Labor and Delivery RN - $1,773 per week

    Magnet Medical • Fishers, IN, United States
    Full-time
    Magnet Medical is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fishers, Indiana.Job Description & Requirements. Magnet Medical Job ID #34244841.Pay package is based on 12...Show more
    Last updated: 30+ days ago • Promoted
    Travel Labor and Delivery RN - $1,931 per week

    Travel Labor and Delivery RN - $1,931 per week

    MedPro Healthcare Staffing • Fishers, IN, United States
    Full-time
    MedPro Healthcare Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fishers, Indiana.Job Description & Requirements. Joint Commission-certified staffing agency, is...Show more
    Last updated: 30+ days ago • Promoted
    Travel - CT Technologist

    Travel - CT Technologist

    Titan Medical Group • Carmel, IN, US
    Full-time
    WHEN YOU WORK FOR US, WE WORK FOR YOU\n.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment y...Show more
    Last updated: 30+ days ago • Promoted
    Associate Actuary

    Associate Actuary

    Munich RE • Fishers, IN, United States
    Full-time
    Amelia, United States; Akron, United States; Ann Arbor, United States; Athens, United States; Atlanta, United States; Augusta, United States. Bremen, United States; Carmel, United States; Cary, Uni...Show more
    Last updated: 30+ days ago • Promoted