Remote QA Manager – Medicare Compliance & Risk

WPS—A health solutions company; Illinois; À distance; USD 85 000 - 115 000; Plein temps

Avantages offerts par ce poste

Remote work options

Bonus opportunities

401(k) with company match

Paid time off

Health insurance

Résumé du poste

WPS Health Solutions is seeking a Quality Assurance Manager to coordinate and oversee QA activities within the Audit and Reimbursement department. The role requires deep expertise in Medicare reimbursement, CMS regulations, and risk assessment to improve quality and ensure compliant cost reporting.

You will provide technical leadership, drive QA process improvements, and communicate findings across management and staff while managing quarterly reviews and associated documentation.

Qualifications

• Bachelor’s degree required in Accounting, Finance, Business Administration or related field.
• 5+ years of Medicare auditing and/or reimbursement experience.
• Thorough knowledge of auditing standards, Government Auditing Standards and Medicare rules.
• Strong analytical, research and communication skills.

Responsabilités

• Coordinate and oversee QA activities for the Audit and Reimbursement department.
• Serve as SME in Medicare reimbursement and CMS regulations.
• Monitor quality through periodic reviews and continuous improvement initiatives.
• Lead or participate in QA process development, risk assessment, and staff training.
• Respond to provider inquiries and audit staff with timely, accurate analyses.

Connaissances

Auditing techniques

Regulatory interpretation

Data analysis

Project management

Communication skills

Formation

Bachelor’s degree in Accounting/Finance/Business Administration

Outils

PS&R knowledge

Description du poste

WPS Health Solutions is seeking a Quality Assurance Manager to coordinate and oversee QA activities within the Audit and Reimbursement department. The role requires deep expertise in Medicare reimbursement, CMS regulations, and risk assessment to improve quality and ensure compliant cost reporting.

You will provide technical leadership, drive QA process improvements, and communicate findings across management and staff while managing quarterly reviews and associated documentation.