Medicare Claims Specialist II (Remote + Benefits)

WPS—A health solutions company; Madison (WI); Remote; USD 22,000 - 31,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or merit

401(k) with match

Job summary

WPS—A health solutions company in Madison, Wisconsin, is hiring a Claims Rep 2 to process Medicare claims from receipt through resolution in compliance with policies and regulations. The role emphasizes timely, accurate claim resolution and strong customer service.

Starting pay is at least $19.00 per hour with on-the-job training Monday–Friday 7:30am–4:00pm CT. After training, flexible 8-hour shifts between 6am and 6pm CT, with remote work options in approved states.

Qualifications

• Data entry proficiency with accuracy and focus.
• Ability to multitask and adapt in a fast-paced environment.
• Strong communication with internal teams, providers and members.
• Attention to detail and adherence to guidelines.

Responsibilities

• Process Medicare claims from receipt to resolution following policies and regulations.
• Handle complex adjustments and reconsiderations including denials and complaints.
• Communicate with providers and internal departments to clarify issues.
• Interact with providers by phone to resolve claims and document outcomes.
• Support CMS performance metrics and maintain quality standards.
• Stay up-to-date with changes in regulations and coding standards.

Skills

Data entry

Multitasking

Customer communications

Problem solving

Independent work

Education

High School Diploma or GED

Post-secondary education in insurance

Job description

WPS—A health solutions company in Madison, Wisconsin, is hiring a Claims Rep 2 to process Medicare claims from receipt through resolution in compliance with policies and regulations. The role emphasizes timely, accurate claim resolution and strong customer service.

Starting pay is at least $19.00 per hour with on-the-job training Monday–Friday 7:30am–4:00pm CT. After training, flexible 8-hour shifts between 6am and 6pm CT, with remote work options in approved states.