Senior Overpayment Recovery Lead - Remote

WPS—A health solutions company; Madison (WI); Hybrid; USD 34,000 - 45,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus opportunities

401(k) with match up to 6%

Health and dental insurance starting 1

Paid time off

Job summary

WPS, a health solutions company, seeks a Senior Overpayment Recovery Specialist to assist the Recovery Team with workflow, inventory, and coordination of activities. You will guide staff and help resolve complex issues while ensuring regulatory compliance.

The role requires Medicare recovery experience, strong communication skills, and the ability to support audits and process improvements across the department.

Qualifications

• Two years Medicare Financial/Overpayment Recovery experience or equivalent in other WPS contracts.
• Knowledge of Overpayment Recovery Regulations and HIGLAS/claims guidelines.
• Ability to interpret regulations and apply to manuals and guidelines.
• Experience with internal/external audits and quality review standards.

Responsibilities

• Assist supervisor with monitoring 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 manuals.
• Research and respond to complex overpayment recovery cases.
• Support audits and quality reviews of completed work.
• Participate in audit processes including CMS and ISO requirements.
• Ensure process consistency and provide technical system assistance.
• Uphold Federal Privacy Act and HIPAA requirements in daily tasks.
• Provide backup for related recovery roles as needed.

Skills

Medicare overpayment experience

Regulatory understanding

Strong written communication

Verbal communication

Mentoring staff

Audits and quality reviews

Problem solving

Training new employees

Education

High School Diploma or equivalent

Job description

WPS, a health solutions company, seeks a Senior Overpayment Recovery Specialist to assist the Recovery Team with workflow, inventory, and coordination of activities. You will guide staff and help resolve complex issues while ensuring regulatory compliance.

The role requires Medicare recovery experience, strong communication skills, and the ability to support audits and process improvements across the department.