WPS Health Solutions

Title: Provider Enrollment Analyst - $18.00/hr, (Must live in vicinity of Madison, WI WPS campus) Location: WI-USA Job Description: Job category: Claims Processing Requisition number: PROVI006111 Full-time Remote Job details U.S. Citizenship is required for this position due to CMS guidelines. 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. Additional Information: - Start Date: July 14, 2026 - Starting Base Pay: $18.00 per hour - Training Schedule: (7 Weeks): 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: Please note that the assigned office for this position is in Madison, WI and remote employees may be required to work at this location at times: WPS Corporate Center Building - 1717 W. Broadway in Madison, WI 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 - U.S. Citizenship required. - 1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialing, 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 credentialing, 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 - 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) Benefits - Bargaining Unit position - Remote 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 - Professional and Leadership Development Programs - Review additional benefits: (https://www.wpshealthsolutions.com/careers/) 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 nearly 80 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 open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique 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 Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.

Collect and analyze data to provide insights for strategic decision-making, support process improvements, and visualize operational data trends, while ensuring data integrity and compliance with industry standards.

Title: Commission and Cash Receipts Analyst Job Category: Finance Requisition Number: COMMI006103 Full-Time Hybrid Locations Madison, WI 53713, USA Colorado, USA Florida, USA GA Remote Illinois, USA Indiana, USA Iowa, USA Michigan, USA MN Remote Missouri, USA Nebraska, USA NJ Remote North Carolina, USA Ohio, USA South Carolina, USA Texas, USA Virginia, USA Wisconsin, USA Job Description: The Commission & Cash Receipts Analyst is responsible for accurate and timely balancing of premium processing, claims refunds, and miscellaneous receipts via lockbox, ACH, ICL, credit card, and onsite deposits. The role balances and releases claims payments and reviews accuracy of offsets. The role supports sales commission and bonus payment administration including, maintaining agency information, updating commission scales, responding to inquiries, correcting system errors, releasing and journalizing payments, balancing 1099’s, and preparing both monthly statements and ad hoc reports. Salary Range 20.00-25.00/hr. The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location Our first consideration will be to have this employee live in the state of Wisconsin to take advantage of Hybrid work and collaboration. Employees within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to be able to be able to work Hybrid 2 days a week on a regular basis. **As a secondary consideration, we do offer remote work in the following approved states: We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin How do I know this opportunity is right for me? If you enjoy the following: - Ensure ACH returns and premium refunds are handled correctly according to standard work instructions - Review lockbox deposits for accuracy and resolve any issues. - Support the review and audit of commission statements ensuring accuracy and timely administration. - Process claim refunds support the review of claim offsets and preparation of claim balancing activities. - Process daily balancing according to standard work instructions (lockbox, on-site, ICL, credit card) - Assist with review and preparation of 1099’s, agency maintenance, and bonus calculations - Other job-related responsibilities may be assigned as required. Minimum Qualifications - High School Diploma or GED or equivalent experience. - One (1) or more years of experience in accounting, finance, or a related field. - Proficient in Microsoft Excel and exposure to technology applications in Finance. - Solid knowledge and understanding of accounting principles, financial reporting, expense and revenue management. - Basic knowledge and understanding of commission applications, systems, and procedures to include Member Services procedures affecting commission payments. - Ability to apply sound judgment and follow established policies and procedures when addressing daily operational and financial issues. - Solid communication skills with the ability to ask clear, targeted questions to obtain the necessary information for task completion. - Experience identifying and implementing process improvements within accounting functions including ability to research and document processes. Preferred Qualifications - Associate’s degree or higher in Accounting preferred. Remote Work Requirements - High speed cable or fiber - Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection Benefits - Remote and hybrid work options available - Performance bonus and/or merit increase opportunities - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately) - Competitive paid time off - Health insurance, dental insurance, and telehealth services start DAY 1 - Professional and Leadership Development Programs Who We Are WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, 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 has been making healthcare easier for the people we serve for nearly 80 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 open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique 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.

Title: Manager of Case Management and Intake Locations: Colorado, USA Florida, USA GA Remote Illinois, USA Indiana, USA Iowa, USA Michigan, USA Missouri, USA Nebraska, USA NJ Remote North Carolina, USA Ohio, USA South Carolina, USA Texas, USA Virginia, USA Wisconsin, USA MN Remote Work Type:Remote, Hybrid, Full Time Job ID: MANAG006102 Job Description: Description Our Manager of Case Management & Intake provides leadership and oversight for the case management clinical team and non-clinical Intake team within our Health Plan. This Manager coordinates patient care programs, ensures quality service delivery and manages staff performance and departmental operations. They develop, implement and monitor case management programs, and intake and discharge planning. This Manager of Case Management & Intake collaborates with other Health Services teams to ensure seamless interdepartmental coordination of services. They identify opportunities for improvement of workflows, executes initiatives, is a key resource for internal departments and represents Health Services on cross-functional projects. Salary Range $110,000 ~ $130,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range. We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to be able to come into the office 2 days a week on a regular basis. How do I know this opportunity is right for me? If you: - Enjoy providing day-to-day managerial direction, leadership, and oversight of Case Management clinical staff and non-clinical Intake teams ensuring compliance with all corporate and departmental policies, procedures, work standards, and strategies. - Can oversee clinical functions, provide direction to clinical staff and serve as subject matter expert for questions and difficult case reviews. - Like to develop, analyze and maintain staff daily/weekly production and compliance. - Have ensured CM and Intake production and quality standards are met. - Work closely with the intake supervisor to monitor department needs and volume of incoming requests. - Thrive while collaborating cross-functionally to develop and implement new Health Services programs and strategies. - Have developed and revised Health Services policies, procedures, and guidelines that direct department processes, continually evaluating to optimize efficiency within departments. - Enjoy evaluating, analyzing, reporting, and responding to case management trends in health care delivery areas. - Are able to recommend and implement changes consistent with Health Services objectives of quality care and reasonable cost. - Can represent Health Services on committees and work groups for various intradepartmental presentations related to Case Management and Intake. - Wan to oversee the maintenance of documentation for internal and vendor authorization processes. Assist with configuration, training and implementation of systems (Aerial, Facets, etc.). Minimum Qualifications - Bachelor’s degree in Nursing or equivalent combination of education and experience; including CCM certification. - Active license as an RN in the State of Wisconsin or a valid multi-state compact license. - 7 or more years of clinical nursing experience. - 3 or more years in a senior level or managerial role in managed care Case Management. - Strong knowledge and understanding of clinical operations, case management and intake processes and procedures. - Knowledge of current medical practices, trends, and patterns of care. - Experience with accreditation standards (e.g., URAC) and regulatory compliance. - Ability to plan, coordinate, implement, and manage projects in a timely and accurate manner. - Strong analytical, problem-solving, and communication skills. - Proficiency with Microsoft Office and clinical systems (e.g., imaging and review platforms). Preferred Qualifications - 5 or more years in a senior level or managerial role in managed care Case Management. - Familiarity with health plan operations, payer/provider relationships, and insurance benefits. - Health insurance background in Point of Service (POS), Preferred Provider Organization (PPO), or Medicare Supplement) plans. - Technical experience with word processing, spreadsheets, and proficiency with electronic medical record (EMR) systems and/or other managed care software. Remote Work Requirements - High speed cable or fiber - Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net). - Please review Remote Worker FAQs for additional information. Benefits - Remote and hybrid work options available - Performance bonus and/or merit increase opportunities - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately) - Competitive paid time off - Health insurance, dental insurance, and telehealth services start DAY 1 - Professional and Leadership Development Programs

Cost Report Auditor Location: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin Job Description: Our Cost Report Auditor is responsible for conducting audits and desk reviews of Medicare Cost Reports in accordance with the Centers for Medicare & Medicaid Services (CMS) regulations. They ensure the accuracy and integrity of statistical and financial data submitted by healthcare providers and supports the effective use of U.S. tax dollars in the Medicare program. This auditor plays a key role in upholding government auditing standards and ensuring cost-effective healthcare delivery. Salary Range $47,000 - $51,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin In this role you will: - Complete audits and desk reviews using the Uniform Desk Review/Audit Program, meeting established interim and monthly production goals. - Prepare audit adjustment reports and complete detailed work papers in alignment with Government Auditing Standards and CMS requirements. - Analyze financial and statistical data, including expense and revenue figures, to assess reasonableness and compliance with federal regulations. - Review provider pricing policies to ensure consistency in charge structures and examine statistical data for proper cost allocation. - Participate in work groups focused on improving work paper guidelines, auditing techniques, and documentation standards. - Communicate with providers providing explanations and supporting documentation and applicable regulations to support audit findings and reimbursement decisions. How do I know this opportunity is right for me? If you: - Thrive in a fast-paced environment that is deadline driven. - Are extremely detailed oriented and can identify inaccuracies easily. - Feel comfortable defending your decisions with data and facts. - Excel at math and problem solving. - Want to work in an environment with strong work life balance with flexible work hours. - Are interested in working remotely in the comfort of your home – no driving time, gas costs, or wear and tear on your vehicle. What will I gain from this role? - Work experience with a management team that is committed to maintaining a high performing work culture. - Learn basic auditing principles that can spark career growth. - A thorough introduction to healthcare reimbursement. - Serving Medicare beneficiaries and providers. - Working in a continuous performance feedback environment. Minimum Qualifications - Bachelor’s degree in Accounting, Finance, Business Administration, or related field, or equivalent post high school education and/or work-related experience. - Strong analytical and decision-making skills. - Exceptional organizational skills with a high degree of attention to details. - Strong verbal and written communication skills. - Solid knowledge and experience with Microsoft Excel. Preferred Qualifications - Knowledge of CMS Medicare Cost Reporting requirements and Government Auditing Standards. - Experience with audit methodologies, financial analysis, and regulatory compliance. Remote Work Requirements - Wired (ethernet cable) internet connection from your router to your computer. - High speed cable or fiber internet - Please review Remote Worker FAQs for additional information Benefits - Remote and hybrid work options available - Performance bonus and/or merit increase opportunities - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately) - Competitive paid time off - Health insurance, dental insurance, and telehealth services start DAY 1 - Professional and Leadership Development Programs Who We Are WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, 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 has been making healthcare easier for the people we serve for nearly 80 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 open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique 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 organizations regarding our culture and workplace: WPS Newsroom - Awards and Recognition. This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws.