WPS—A health solutions company
Medicare Outreach and Education Specialist (HH & H)
WPS—A health solutions company, Indiana, Pennsylvania, us, 15705
Overview
Medicare Outreach and Education Specialist (HH & H)
role at
WPS—A health solutions company
is a role within the Medicare Program that focuses on developing and delivering educational content to the provider community regarding current and upcoming CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors while working in a fast-paced, remote environment. The education is provided to Medicare providers, coders, billers, and compliance staff to help them understand the Medicare program and stay informed about changes. The role supports providers in developing best practices to avoid coverage and billing errors and to protect the Medicare Trust Fund. The Outreach and Education Specialist emphasizes positive customer experience through relationship building with providers, CMS, and other stakeholders. Responsibilities
Develop and deliver educational content to the provider community regarding CMS regulations. Create educational materials and presentations; host events and training sessions. Analyze data (error data, geographical data, and regulatory changes) to identify education needs and reduce billing errors. Improve provider education and awareness of organizational services, programs, and initiatives through outreach activities. Collaborate with clinical and administrative teams to understand provider challenges and develop targeted solutions. Serve as a resource for providers on updates in guidelines, policies, billing procedures and regulatory requirements. Coordinate with internal teams (Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to communicate issues to POE staff. Establish and maintain a POE Advisory Group (POE AG) to assist contractors in creating and implementing provider education strategies. Minimum Qualifications
Bachelor’s Degree in Communications, Health Education, Nursing or related field, or equivalent combination of education and experience. 3 or more years of experience in a role supporting Medicare. 1 or more years specifically in Medicare communications. Demonstrated experience developing educational materials and presentations. Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and PO&E processes. Solid knowledge of medical billing, coding, and insurance processes. Proficient with Microsoft Office Suite and using various modes of technology to deliver training (e.g., YouTube Channel, WebEx). Excellent written and verbal communication skills with the ability to present complex information clearly to diverse audiences. Strong interpersonal and relationship-building skills. Ability to travel for onsite training and education sessions; travel is approximately 15% in the future. Preferred Qualifications
CMS knowledge of the Home Health and Hospice program. Strong facilitation, presentation and training experience to large groups. Experience processing Home Health and Hospice appeals. MAC contractor experience with FISS, MCS and MAS systems. Remote Work Requirements
Wired (ethernet) 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 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 salary and a 50% match for the next 2% (100% vested immediately) Competitive paid time off Health, dental, and telehealth services start DAY 1 Professional and Leadership Development Programs See full benefits at the company careers page 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 plans for businesses. We process claims and provide customer support for Medicare beneficiaries and manage benefits for military personnel. WPS has a long-standing history of serving the community and values military and veteran readiness. Culture
Our culture values open, empowering, and inclusive teamwork with a focus on engagement and innovation. We strive to recognize and leverage diverse perspectives to fuel agility and high-performing teams. Employment details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Other Industries: Insurance This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). The role is subject to applicable federal regulations, CMS contract requirements, and WPS internal policies, including data security, privacy, confidentiality, and program integrity. CMS contractors and personnel are subject to screening and background checks prior to access to information systems and sensitive data.
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Medicare Outreach and Education Specialist (HH & H)
role at
WPS—A health solutions company
is a role within the Medicare Program that focuses on developing and delivering educational content to the provider community regarding current and upcoming CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors while working in a fast-paced, remote environment. The education is provided to Medicare providers, coders, billers, and compliance staff to help them understand the Medicare program and stay informed about changes. The role supports providers in developing best practices to avoid coverage and billing errors and to protect the Medicare Trust Fund. The Outreach and Education Specialist emphasizes positive customer experience through relationship building with providers, CMS, and other stakeholders. Responsibilities
Develop and deliver educational content to the provider community regarding CMS regulations. Create educational materials and presentations; host events and training sessions. Analyze data (error data, geographical data, and regulatory changes) to identify education needs and reduce billing errors. Improve provider education and awareness of organizational services, programs, and initiatives through outreach activities. Collaborate with clinical and administrative teams to understand provider challenges and develop targeted solutions. Serve as a resource for providers on updates in guidelines, policies, billing procedures and regulatory requirements. Coordinate with internal teams (Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to communicate issues to POE staff. Establish and maintain a POE Advisory Group (POE AG) to assist contractors in creating and implementing provider education strategies. Minimum Qualifications
Bachelor’s Degree in Communications, Health Education, Nursing or related field, or equivalent combination of education and experience. 3 or more years of experience in a role supporting Medicare. 1 or more years specifically in Medicare communications. Demonstrated experience developing educational materials and presentations. Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and PO&E processes. Solid knowledge of medical billing, coding, and insurance processes. Proficient with Microsoft Office Suite and using various modes of technology to deliver training (e.g., YouTube Channel, WebEx). Excellent written and verbal communication skills with the ability to present complex information clearly to diverse audiences. Strong interpersonal and relationship-building skills. Ability to travel for onsite training and education sessions; travel is approximately 15% in the future. Preferred Qualifications
CMS knowledge of the Home Health and Hospice program. Strong facilitation, presentation and training experience to large groups. Experience processing Home Health and Hospice appeals. MAC contractor experience with FISS, MCS and MAS systems. Remote Work Requirements
Wired (ethernet) 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 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 salary and a 50% match for the next 2% (100% vested immediately) Competitive paid time off Health, dental, and telehealth services start DAY 1 Professional and Leadership Development Programs See full benefits at the company careers page 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 plans for businesses. We process claims and provide customer support for Medicare beneficiaries and manage benefits for military personnel. WPS has a long-standing history of serving the community and values military and veteran readiness. Culture
Our culture values open, empowering, and inclusive teamwork with a focus on engagement and innovation. We strive to recognize and leverage diverse perspectives to fuel agility and high-performing teams. Employment details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Other Industries: Insurance This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). The role is subject to applicable federal regulations, CMS contract requirements, and WPS internal policies, including data security, privacy, confidentiality, and program integrity. CMS contractors and personnel are subject to screening and background checks prior to access to information systems and sensitive data.
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