Senior Overpayment Recovery Lead (Remote)

WPS—A health solutions company; Iowa; Remote; USD 27,000 - 39,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or meritIncrease

401(k) with full match for 3% + 50% on

Health, dental and telehealth benefits

Professional and LeadershipDevelopment

Job summary

WPS—A health solutions company seeks a Senior Overpayment Recovery Specialist to support the Overpayment Recovery Team with direction, workflow, and coordination of activities. You will advise staff, help resolve complex issues, and ensure compliance with applicable regulations, HIPAA, and program integrity requirements.

The role involves mentoring, training, and preparing operational reports related to Recovery Audit activities, with remote work options in approved states and a starting base

Qualifications

• Two (2) or more years Medicare Financial/Overpayment Recovery experience with proficiency in all overpayment recovery areas, or applicable adjustment experience in other WPS contracts.
• Knowledge of Overpayment Recovery Regulations and related procedures.
• Strong written and verbal communication skills for mentoring staff, preparing reports, and documenting procedures.

Responsibilities

• Assist supervisor with monitoring, workload inventories, and escalation 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 work.
• Support internal and external audit processes (OMB-A123, SSAE-16, ISO, Internal Audit).
• Ensure process consistency and test system changes; report issues.
• Comply with privacy and confidentiality requirements under HIPAA and related policies.

Skills

Medicare Recovery

Regulatory interpretation

Audit knowledge

Communication skills

Training & mentoring

Tools

HIGLAS system

Job description

WPS—A health solutions company seeks a Senior Overpayment Recovery Specialist to support the Overpayment Recovery Team with direction, workflow, and coordination of activities. You will advise staff, help resolve complex issues, and ensure compliance with applicable regulations, HIPAA, and program integrity requirements.

The role involves mentoring, training, and preparing operational reports related to Recovery Audit activities, with remote work options in approved states and a starting base