Medicare QA & Reimbursement Lead (Remote)

WPS Health Solutions; Marion (IL); À distance; USD 85 000 - 115 000; Plein temps

Avantages offerts par ce poste

Remote work options

Performance bonus

401(k) with 100% match up to 3%

Health insurance

Dental insurance

Telehealth

Professional development opportunities

Résumé du poste

WPS Health Solutions seeks a Quality Assurance Manager to coordinate QA activities for the Audit and Reimbursement department. This role serves as a Medicare reimbursement and cost reporting SME, guiding QA process development and monitoring to ensure CMS compliance and continuous improvement.

The position offers remote work within approved states and a salary range of $85,000–$115,000, with opportunities for professional development and performance-based incentives.

Qualifications

• Bachelor’s degree or equivalent in a related field.
• 5+ years in Medicare auditing or reimbursement activity.
• Thorough knowledge of Government Auditing Standards and Medicare rules.

Responsabilités

• Coordinate and oversee QA activities for Audit and Reimbursement.
• Interpret CMS regulations and Medicare reimbursement principles.
• Lead risk assessment and continuous improvement initiatives.
• Respond to audit inquiries and conduct IQC reviews.
• Facilitate quarterly meetings with management and staff.

Connaissances

Medicare auditing

Cost reporting

Regulatory interpretation

Analytical thinking

Data analysis

Formation

Bachelor's degree in Accounting/Finance/Business

Outils

PS&R

Description du poste

WPS Health Solutions seeks a Quality Assurance Manager to coordinate QA activities for the Audit and Reimbursement department. This role serves as a Medicare reimbursement and cost reporting SME, guiding QA process development and monitoring to ensure CMS compliance and continuous improvement.

The position offers remote work within approved states and a salary range of $85,000–$115,000, with opportunities for professional development and performance-based incentives.