Medicare Outreach and Education Specialist (HH & H)

WPS Health Solutions; Columbus (OH); Remote; USD 61,000 - 90,000; Full time

Job summary

A leading health solutions company is seeking a Medicare Outreach & Education Specialist to develop and deliver educational materials to providers. The role focuses on relationship-building with Medicare providers and aims to reduce billing errors. Ideal candidates should have a Bachelor's degree and experience in Medicare communications. Remote work options are available.

Benefits

Remote and hybrid work options

401(k) with matching

Health insurance starting DAY 1

Competitive paid time off

Qualifications

• 3+ years experience in a role supporting Medicare.
• 1+ years specifically in Medicare communications.
• Experience developing educational materials and presentations.
• Extensive knowledge of Medicare Part A and B guidelines.

Responsibilities

• Develop and deliver education to the provider community.
• Create and host educational events.
• Analyze data to improve provider education.

Skills

Experience with Medicare

Relationship-building

Educational material development

Data analysis

Communication skills

Education

Bachelor's Degree in Communications, Health Education, or Nursing

Tools

Microsoft Office Suite

Job description

Role Snapshot

Our Medicare Outreach & Education Specialist (HH & H - Home Health and Hospice) plays a crucial role in our Medicare Program by developing and delivering educational content to the provider community regarding current and upcoming CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, all while working in a fast-paced, remote environment. This education is provided to Medicare providers, coders, billers, and compliance staff to help them understand the Medicare program and be informed about changes. The role assists providers in developing best practices to avoid coverage and billing errors to reduce error rates and protect the Medicare Trust Fund. The Outreach and Education Specialist focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders.

Salary Range

$61,000 ~ $90,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.

Work Location

We are open to remote work in the following approved states: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin

Opportunity Fit

If you:

• Possess experience working with Medicare specifically in the Home Health and Hospice space.
• Thrive in developing and maintaining positive relationships with healthcare providers, clinics, and medical staff.
• Enjoy planning, developing, coordinating and delivering educational sessions, workshops, and training materials tailored to provider needs.
• Can analyze error data, geographical data, track Medicare regulations, WPS policy guidelines, coverage issues, and keep abreast of upcoming legislation to determine areas for additional education needs.
• Like to conduct outreach activities that increase provider engagement and awareness of organizational services, programs, and initiatives.
• Have collaborated with clinical and administrative teams to understand provider challenges and develop targeted solutions.
• Would enjoy serving as a resource for providers regarding updates in guidelines, policies, billing procedures and regulatory requirements.
• Can Coordinate with internal teams (i.e., Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to ensure identified issues are communicated and shared with Provider Outreach & Education (POE) staff.
• Can establish and maintain a POE Advisory Group (POE AG) to assist contractors in creation, implementation, and review of provider education strategies and efforts.

Minimum Qualifications

• Bachelor's Degree in Communications, Health Education, Nursing OR related field OR equivalent combination of education and experience.
• 3 or more years of experience in a role supporting Medicare.
• 1 or more years specifically in Medicare communications.
• Demonstrated experience developing educational materials and presentations.
• Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and PO&E processes.
• Solid knowledge and understanding of medical billing, coding, and insurance processes.
• Proficient with Microsoft Office Suite and using various modes of technology to deliver training (i.e., YouTube Channel, WebEx, etc.).
• Excellent written and verbal communication skills with the ability to present complex information clearly and effectively to diverse audiences.
• Strong interpersonal and relationship-building skills.
• Ability to travel for onsite training and education sessions - Travel will be approximately 15% in the future.

Preferred Qualifications

• CMS knowledge of the Home Health and Hospice program.
• Strong facilitation, presentation and training experience to large groups of people.
• Experience processing Home Health and Hospice appeals.
• MAC contractor experience with FISS, MCS and MAS 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 https://speedtest.net)
• 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: https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml

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.

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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.