Remote QA Manager - Medicare Audit Leader

WPS—A health solutions company; Michigan; Remote; USD 85,000 - 115,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and merit increases

401(k) with a 100% match for the first

3% salary match; 50% next 2%

Health insurance

Dental insurance

Telehealth services

Professional and Leadership Develop

Career development

Job summary

WPS, a health solutions company, seeks a QA Manager to oversee the Quality Assurance activities for the Audit and Reimbursement department. You will act as a subject matter expert in Medicare reimbursement and cost reporting, guiding technical leadership and continuous QA improvement.

The role ensures adherence to CMS regulations, leads risk assessment, and supports responsible stewardship of Medicare funds. Remote work options may be available within approved states.

Qualifications

• Bachelor’s degree or equivalent post high school education/work experience.
• 5+ years in Medicare auditing and/or reimbursement.
• Knowledge of auditing techniques, Government Auditing Standards, and Medicare rules.
• Understanding of PS&R and claims processing.

Responsibilities

• Coordinate and oversee QA activities for Medicare Audit and Reimbursement.
• Serve as SME in Medicare reimbursement and cost reporting.
• Lead or participate in QA reviews, develop rebuttals, and ensure CMS compliance.

Skills

Analytical thinking

Decision making

Group facilitation

Project management

Data analysis

Verbal communications

Written communications

Researching skills

Education

Bachelor’s degree in Accounting, Finance, Business Administration, or related field

Job description

WPS, a health solutions company, seeks a QA Manager to oversee the Quality Assurance activities for the Audit and Reimbursement department. You will act as a subject matter expert in Medicare reimbursement and cost reporting, guiding technical leadership and continuous QA improvement.

The role ensures adherence to CMS regulations, leads risk assessment, and supports responsible stewardship of Medicare funds. Remote work options may be available within approved states.