Posted in Other 7 days ago.
Are you considering a career move away from direct patient care and want to use your nursing knowledge in a new and different way? If you desire a remote nursing position with daytime hours and no on-call work this position may be for you!
The Medical Review Nurse Analyst will review medical documentation for post pay claims submitted to Medicare to ensure providers are billing and being paid appropriately for services provided based on Medicare guidelines, specifically for beneficiaries eligible for both Medicare and Medicaid. The Medical Review Nurse Analyst will review claims and deliver provider education as warranted.
In this role you will:
This role could be a good fit if you:
You'll benefit from this experience by:
You need to have:
We also prefer:
This team is comprised of clinical and operational staff
Compensation and Benefits
Who We Are
WPS Health Solutions is an innovator in health insurance and a worldwide leader in claims administration, serving millions of beneficiaries in the United States and abroad.
Founded in 1946, WPS offers health insurance plans for individuals, families, and seniors, and group plans for small and large businesses. We are a world-class claims processor and program administrator for the government's Medicare program. And we manage benefits for millions of active-duty and retired military personnel and their families.
Our Purpose and Values
Our purpose is to make healthcare easier for those we serve. Click Here
Our values - Customer Focused, Individual Responsibility, Mutual Respect, and Driven & Passionate - are the core of who we are and how we conduct business every day.
WPS Health Insurance
WPS Health Insurance offers high-quality health insurance plans for individuals and families, Medicare supplement plans for seniors, and group health plans for businesses of every size.
Military and Veterans Health
WPS Military and Veterans Health administers claims and provides customer service and related activities for the U.S. Department of Defense and the U.S. Department of Veterans Affairs and their beneficiaries.
Government Health Administrators
WPS Government Health Administrators manages Medicare Part A and Part B benefits for more than 7 million beneficiaries. As one of the largest contractors for the Centers for Medicare & Medicare Services, we've served Medicare beneficiaries and their health care providers since 1966.
WPS Health Plan
WPS Health Plan offers Health Maintenance Organization and Point-of-Service plans to the group and individual markets in eastern and north-central Wisconsin, plus third-party administrator services.
EPIC Specialty Benefits
EPIC Specialty Benefits provides businesses group insurance products that cover:
Stay connected: Sign up for Job Alerts
7 minutes ago
9 minutes ago
San Jacinto College
about 1 hour ago
Targa Resources Corp
less than a minute ago
University of Kentucky
3 minutes ago
8 minutes ago