Provider Enrollment Analyst / Credentialing, fully remote

Provider Enrollment Analyst / Credentialing

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’ Performance-Based 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.

From 2021 to 2023, WPS Health Solutions was recognized for several awards:

• Madison, Wisconsin’s Top Workplaces
• USA Top Workplaces and the cultural excellence awards for Remote Work and Work-Life Flexibility
• Achievers 50 Most Engaged Workplaces® with the further honor of Achievers “Elite 8” winner in the category of Culture Alignment
• DAV Patriot Employer
• VETS Indexes 4 Star Employer
• BBB Torch Award for Ethics from Better Business Bureau of Wisconsin

Role Snapshot

The Provider Enrollment Analyst will approve, deny, or return applications submitted by Medicare providers. This work is important in helping providers enroll in the Medicare program.

In this role you will:

• Utilize on-line Medicare files/systems to verify research, update, and document enrollment information.
• Respond to provider/customer enrollment telephone and written inquiries.
• Ensure all provider enrollment data is properly controlled and tracked to ensure applications are approved or denied within standards of timeliness established by department and Centers for Medicare and Medicaid Services (CMS).
• Enter data into on-line national database and internal provider files (PECOS).
• Research and verify proper fees and inspections have been completed on certain suppliers.

How do I know this opportunity is right for me? If you:

• Possess confidence in your skills navigating a computer to process applications efficiently through multiple operating systems.
• Prioritize effectively, stay on task, and work independently.
• Are comfortable critically examining, analyzing and reviewing work items in detail for accuracy.
• Possess strong communication skills, both verbal and written.
• Enjoy research and problem-solving.

What will I gain from this role?

• Helping our providers enroll in Medicare to support the senior community.
• Having the opportunity to earn more by being a top performer.
• Enjoying flexible work hours.
• Opportunity to work remotely in the comfort of your home – no driving time, gas costs, or wear and tear on your vehicle.
• Experience working in an environment that serves our Nation’s military, veterans, Guard and Reserves and Medicare beneficiaries.
• Working in a continuous performance feedback environment.

Minimum Qualifications

• High school diploma or equivalent.
• 1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialling, billing or medical reimbursement.

Preferred Qualifications

• Associate degree in business administration, insurance, healthcare, or related fields.
• 2 or more years of business experience, including working in the insurance industry, claims processing, health care credentialling, billing or medical reimbursement.
• Experience interpreting government regulations and applying to current processes.
• Course work in insurance, medical, customer service and/or financial.
• 1 or more years of computer and navigation experience preferably working with dual monitors
• Good work ethic and good attendance.
• Ability to communicate effectively over the phone.
• Experience working in a production-based environment.

Remote Work Requirements

• Wired (ethernet cable) internet connection from your router to your computer (add this bullet point only IF your role requires a wired connection)
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)

Additional Information:

• Start Date: Monday, May 6th, 2024
• Starting Base Pay: $19.50 per hour
• Training Schedule: (5-6Weeks): Monday through Friday, 8:00-4:35pm CST
• Scheduled Shift: Monday through Friday, 6:00am-6:00pm, Flex Scheduling, max of 10 hours per day and 40 hours minimum per week
• Work Location: This position is 100% remote . To help strengthen communication, provide a sense of community, and improve the overall remote work experience, the assigned office community based on the position’s division is: Omaha, NE

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Employee Resource Groups
• Professional and Leadership Development Programs
• Review additional benefits here

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)