Senior Overpayment Recovery Lead — Remote

WPS Health Solutions; Denver (CO); A distancia; USD 27.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work options available

Performance bonus/merit increase

401(k) with full match

Competitive PTO

Health insurance Day 1

Professional development

Descripción de la vacante

WPS Health Solutions is seeking a Senior Overpayment Recovery Specialist to support the Overpayment Recovery Team with direction, workflow, and issue resolution. You will mentor staff and coordinate daily operations in a remote-friendly environment.

The role requires knowledge of Medicare recovery, audits, privacy and regulatory compliance, and the ability to analyze complex cases. Remote work is available for approved states; training and shift expectations are defined.

Formación

• Two (2) or more years Medicare Financial/Overpayment Recovery experience.
• Demonstrated knowledge of Overpayment Recovery Regulations and related procedures.
• Knowledge of internal/external audit procedures and quality review standards.
• Strong written and verbal communication for mentoring staff and documenting procedures.

Responsabilidades

• Assist supervisor with monitoring, analyzing, and escalating department workload inventories for timely handling.
• Mentor new employees and provide process training.
• Prepare daily, weekly, and monthly operations reports, including Recovery Audit activities.
• Interpret regulations and develop/update work instructions and process manuals.
• Research and respond to complex Overpayment Recovery cases.
• Perform audits and quality reviews of unit completed work.
• Assist with internal and external audit processes (OMB-A123, SSAE-16, ISO Surveillance).
• Ensure jurisdictional process consistency and test system changes.
• Ensure compliance with HIPAA and Privacy Act requirements.
• Provide back-up to related roles as needed.

Conocimientos

Overpayment Recovery

Medicare Regulations

Audit Procedures

Regulatory Interpretation

Mentoring

Communication Skills

Team Collaboration

Research & Analysis

Training Capability

Medicare Recovery Experience

HIGLAS Knowledge

HIPAA Knowledge

Educación

High School Diploma or equivalent

Descripción del empleo

WPS Health Solutions is seeking a Senior Overpayment Recovery Specialist to support the Overpayment Recovery Team with direction, workflow, and issue resolution. You will mentor staff and coordinate daily operations in a remote-friendly environment.

The role requires knowledge of Medicare recovery, audits, privacy and regulatory compliance, and the ability to analyze complex cases. Remote work is available for approved states; training and shift expectations are defined.