Remote Medicare Claims Specialist II

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

Benefits offered by this job

Remote work options

Performance bonus

401(k) with match

Paid time off

Health insurance

Dental insurance

Telehealth services

Development programs

Job summary

WPS, a health solutions company, is seeking a Claims Rep 2 to process Medicare claims from receipt to resolution in accordance with policies and regulations. The role emphasizes timely, accurate resolutions and high-quality customer service, with remote work options across multiple states.

The position includes on-the-job training, flexible 8-hour shifts, and opportunities for performance-based bonuses. Ideal candidates have 1+ year in medical billing, data entry accuracy, and strong

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ year experience in hospital, clinic, or medical office billing.
• 1+ year post-high school education in insurance/medical studies with computer experience.
• Demonstrated data entry proficiency with accuracy.

Responsibilities

• Review Medicare Part A and B claims using federal guidelines for processing and payment rules.
• Handle complex adjustments including patient complaints and denials.
• Communicate with providers, departments, and members to obtain information.
• Interact with providers by phone to resolve claim problems and coordinate with CMS/other entities.
• Support CMS performance metrics and maintain quality/production standards.
• Provide back-up for department staff and stay current with regulations and policies.

Skills

Data entry

Multitasking

Problem solving

Customer communications

Independent work

Education

Post-high school coursework in insurance/medical studies

Job description

WPS, a health solutions company, is seeking a Claims Rep 2 to process Medicare claims from receipt to resolution in accordance with policies and regulations. The role emphasizes timely, accurate resolutions and high-quality customer service, with remote work options across multiple states.

The position includes on-the-job training, flexible 8-hour shifts, and opportunities for performance-based bonuses. Ideal candidates have 1+ year in medical billing, data entry accuracy, and strong