Remote QA Manager, Medicare Reimbursement & Compliance

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

Benefits offered by this job

Remote work options

Performance bonus

401(k) match

Health insurance

Professional development

Job summary

WPS, a health solutions company, is seeking a Quality Assurance Manager to coordinate QA activities for the Audit and Reimbursement department with subject-matter expertise in Medicare reimbursement and cost reporting.

You will provide technical leadership, monitor QA through reviews, ensure CMS compliance, and drive ongoing improvements to QA processes and documentation while working remotely in approved states, including Minnesota.

Qualifications

• Bachelor’s degree or equivalent in accounting/finance or related field.
• 5+ years in Medicare auditing or reimbursement.
• Extensive knowledge of auditing techniques and Government Auditing Standards.
• Strong understanding of PS&R and claims processing.

Responsibilities

• Coordinate QA activities for Medicare Audit and Reimbursement.
• Interpret CMS regulations and Medicare reimbursement principles.
• Respond to provider inquiries and internal/external customers.
• Lead or participate in cross-functional work groups and projects.
• Support IQC reviews and quarterly reviews.
• Review forms for accuracy and testing.

Skills

Analytical skills

Decision making

Judgment

Group facilitation

Project management

Data analysis

Risk assessment

Written communications

Verbal communications

Research skills

CMS regulations

Medicare rules

Education

Bachelor's degree or equivalent

Job description

WPS, a health solutions company, is seeking a Quality Assurance Manager to coordinate QA activities for the Audit and Reimbursement department with subject-matter expertise in Medicare reimbursement and cost reporting.

You will provide technical leadership, monitor QA through reviews, ensure CMS compliance, and drive ongoing improvements to QA processes and documentation while working remotely in approved states, including Minnesota.