Remote Medicare Claims Specialist II

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

Benefits offered by this job

Remote work options available

Performance bonus opportunities

401(k) with strong match

Competitive PTO

Job summary

WPS is seeking a Claims Rep 2 to process Medicare claims from receipt to resolution, ensuring accuracy, quality, and timely service. Training occurs Monday–Friday, 7:30am–4:00pm CT, with 8-hour shifts post-training between 6am–6pm CT. Remote work is available in several states, including Illinois.

Responsibilities include reviewing Part A/Part B claims, handling complex adjustments, and communicating with providers and members to resolve issues while adhering to CMS guidelines and WPS policies.

Qualifications

• High School Diploma or GED or equivalent required.
• 1+ years hospital/clinic/medical office billing experience.
• 1+ years post-high school education in insurance/medical studies; experience with computer and customer communications.

Responsibilities

• Review Medicare Part A and Part B claims using federal and internal guidelines.
• Handle complex adjustments including reconsiderations and denials.
• Communicate with internal departments, providers, and members to obtain information.

Skills

Data entry

Attention to detail

Multitasking

Communication skills

Independent work

Education

High School Diploma or GED

Post-high school coursework in insurance/medical studies

Job description

WPS is seeking a Claims Rep 2 to process Medicare claims from receipt to resolution, ensuring accuracy, quality, and timely service. Training occurs Monday–Friday, 7:30am–4:00pm CT, with 8-hour shifts post-training between 6am–6pm CT. Remote work is available in several states, including Illinois.

Responsibilities include reviewing Part A/Part B claims, handling complex adjustments, and communicating with providers and members to resolve issues while adhering to CMS guidelines and WPS policies.