Job Information
WPS HEALTH SOLUTIONS Cost Report Auditor in MADISON, Wisconsin
JOB REQUIREMENTS: Description Who We Are WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS Health Solutions has been making health care easier for the people we serve for more than 75 years. Proud to be military and veteran ready. Culture Drives Our Success WPS\' Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities. We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition Role Snapshot The Cost Report Reopening Specialist reviews previously settled Medicare cost reports for errors and omissions. Upon locating an error, cost report reopening specialists revise to ensure proper payment for the Medicare provider. In this role you will: Prepare detailed work papers to support audit adjustments to Medicare cost reports to ensure compliance with Government Auditing Standards. Verify Hospitals and other health care providers are not overpaid. Review and analyze complex financial statements and records. Secure PHI (Personal Health Information) and PII (Personal Identification Information). Utilize auditor judgment to determine scope of review when reviewing Medicare cost reports. Provide written and verbal communication to hospitals and other health care providers. Review and communicate Medicare regulation and policy to hospitals and other health care providers. Provide written and verbal communication to Centers for Medicare and Medicaid Services (CMS) and other Government Agencies including Department of Justice (DOJ), General Accounting Office (GAO), Medicare management, and Provider Reimbursement Review Board (PRRB). Assist Cost Report Appeals Specialist in resolving appeals and obtaining Administrative Resolutions to avoid Appeal hearing procedures Review, update, and initiate new procedures related to revising Medicare cost reports more accurately and... For full info follow application link. Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/30762351AC43423C Qualified females, minorities, and special disabled veterans and other veterans are encouraged to apply.
