Medicare Claims Specialist II — Remote & Flexible

WPS—A health solutions company; Michigan; Remote; USD 22,000 - 31,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and merit increases

401(k) match

Job summary

WPS Health Solutions seeks a Claims Rep 2 to process Medicare claims from receipt to resolution, ensuring accuracy and timely resolutions according to policies and regulations.

Hourly rate starts at $19/hour with training Monday–Friday and flexible 8-hour shifts after training. Remote work is available in several states; benefits include health coverage, 401(k) matching, and development programs.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ years hospital/clinic/medical office billing experience.
• 1+ year post-high school education or coursework in insurance or medical-related studies.

Responsibilities

• Review Medicare Part A and Part B claims with guidelines to ensure proper processing.
• Handle complex adjustments and reconsiderations including patient complaints and denials.
• Communicate with internal departments, providers, and members to obtain information and clarify issues.
• Interact with providers by phone to resolve claim problems and coordinate with other contractors.

Skills

Medicare adjudication

Data entry

Customer communications

Multitasking

Education

High School Diploma or GED

Insurance/medical coursework

Tools

Hospital billing software

CMS claim forms CMS-1450 / CMS-1500

Job description

WPS Health Solutions seeks a Claims Rep 2 to process Medicare claims from receipt to resolution, ensuring accuracy and timely resolutions according to policies and regulations.

Hourly rate starts at $19/hour with training Monday–Friday and flexible 8-hour shifts after training. Remote work is available in several states; benefits include health coverage, 401(k) matching, and development programs.