Remote Medicare QA & Reimbursement Lead

WPS—A health solutions company; New Jersey; Remoto; USD 85.000 - 115.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work options available

Performance bonus and/or merit raise

401(k) with 100% match for first 3% &

Merit increase opportunities

Paid time off

Health insurance

Dental insurance

Telehealth

Professional and LeadershipDevelopment

Descrizione del lavoro

WPS, a health solutions company, is seeking a Quality Assurance Manager to oversee QA activities for the Audit and Reimbursement department. You will serve as a subject matter expert in Medicare reimbursement and cost reporting, provide technical leadership, and drive the QA process improvements in a CMS-regulated environment.

The role focuses on risk assessment, CMS interpretation, and ongoing development of quality assurance programs, with the option for remote work among approved states

Competenze

• Bachelor’s degree in Accounting, Finance, Business Administration or related field, or equivalent experience.
• 5+ years Medicare auditing or reimbursement experience.
• In-depth knowledge of Government Auditing Standards and Medicare rules.
• Understanding of PS&R and claims processing.
• Strong research, analytical, and communication abilities.

Mansioni

• Coordinate and oversee QA activities for the Audit and Reimbursement department.
• Serve as Medicare reimbursement and cost reporting SME and provide technical leadership.
• Monitor quality through periodic reviews and drive QA process improvements.
• Interpret CMS regulations and support risk assessment and continuous improvement.

Conoscenze

Research skills

Analytical thinking

Decision making

Group facilitation

Project management

Data analysis

Risk assessment

Written communication

Verbal communication

Formazione

Bachelor’s degree

Descrizione del lavoro

WPS, a health solutions company, is seeking a Quality Assurance Manager to oversee QA activities for the Audit and Reimbursement department. You will serve as a subject matter expert in Medicare reimbursement and cost reporting, provide technical leadership, and drive the QA process improvements in a CMS-regulated environment.

The role focuses on risk assessment, CMS interpretation, and ongoing development of quality assurance programs, with the option for remote work among approved states