WPS—A health solutions company
Clinical Medicare Outreach and Education Specialist (HH & H)
WPS—A health solutions company, Lansing, Michigan, United States
Overview
Clinical Medicare Outreach and Education Specialist (HH & H - Home Health and Hospice) role at
WPS—A health solutions company . This position develops and delivers educational content to the provider community regarding current and upcoming CMS regulations. The specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, in a fast-paced, remote environment. This education is provided to Medicare providers such as physicians, non-physician practitioners, nurses, therapists, coders, billers, and compliance staff to help them understand the Medicare program and changes. The role focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders. Role Snapshot
Our Clinical Medicare Outreach & Education Specialist (HH & H - Home Health and Hospice) plays a crucial role in our Medicare Program by developing and delivering educational content to the provider community regarding CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, all while working remotely. Responsibilities
Develop and deliver educational content to providers regarding current and upcoming CMS regulations. Create educational materials and host events to support provider education. Analyze data to identify education needs and reduce billing and coverage errors. Assist providers in developing best practices to avoid coverage and billing errors and protect the Medicare Trust Fund. Foster positive relationships with providers, CMS, and other stakeholders to enhance customer experience. 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 in the creation, implementation, and review of provider education strategies. Minimum Qualifications
Bachelor’s Degree in Communications, Health Education, Nursing or related field, or equivalent combination of education and experience. 2+ years as a Medical Review Nurse Analyst with Medicare principles and guidelines. 3+ years in a role supporting Medicare. 1+ year specifically in Medicare communications. Experience developing educational materials and presentations. Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and POE processes. Solid knowledge of medical billing, coding, and insurance processes. Proficient with Microsoft Office and delivering training via multiple modalities (e.g., YouTube Channel, WebEx). Excellent written and verbal communication skills for diverse audiences. Strong interpersonal and relationship-building skills. Ability to travel for onsite training and education sessions – travel approximately 15% in the future. Preferred Qualifications
4+ years of clinical nursing experience. CMS knowledge of Home Health and Hospice programs. Strong facilitation, presentation and training experience for large groups. Experience processing Home Health and Hospice appeals. MAC contractor experience with FISS, MCS and MAS systems. Remote Work Requirements
Wired ethernet connection from router to computer High-speed cable or fiber internet Minimum 10 Mbps downstream and 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 website Compliance & Workplace Information
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 internal policies, including standards for data security, privacy, confidentiality, and program integrity. CMS contractors and personnel are subject to screening and background investigation prior to access to information systems and/or sensitive data.
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Clinical Medicare Outreach and Education Specialist (HH & H - Home Health and Hospice) role at
WPS—A health solutions company . This position develops and delivers educational content to the provider community regarding current and upcoming CMS regulations. The specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, in a fast-paced, remote environment. This education is provided to Medicare providers such as physicians, non-physician practitioners, nurses, therapists, coders, billers, and compliance staff to help them understand the Medicare program and changes. The role focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders. Role Snapshot
Our Clinical Medicare Outreach & Education Specialist (HH & H - Home Health and Hospice) plays a crucial role in our Medicare Program by developing and delivering educational content to the provider community regarding CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, all while working remotely. Responsibilities
Develop and deliver educational content to providers regarding current and upcoming CMS regulations. Create educational materials and host events to support provider education. Analyze data to identify education needs and reduce billing and coverage errors. Assist providers in developing best practices to avoid coverage and billing errors and protect the Medicare Trust Fund. Foster positive relationships with providers, CMS, and other stakeholders to enhance customer experience. 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 in the creation, implementation, and review of provider education strategies. Minimum Qualifications
Bachelor’s Degree in Communications, Health Education, Nursing or related field, or equivalent combination of education and experience. 2+ years as a Medical Review Nurse Analyst with Medicare principles and guidelines. 3+ years in a role supporting Medicare. 1+ year specifically in Medicare communications. Experience developing educational materials and presentations. Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and POE processes. Solid knowledge of medical billing, coding, and insurance processes. Proficient with Microsoft Office and delivering training via multiple modalities (e.g., YouTube Channel, WebEx). Excellent written and verbal communication skills for diverse audiences. Strong interpersonal and relationship-building skills. Ability to travel for onsite training and education sessions – travel approximately 15% in the future. Preferred Qualifications
4+ years of clinical nursing experience. CMS knowledge of Home Health and Hospice programs. Strong facilitation, presentation and training experience for large groups. Experience processing Home Health and Hospice appeals. MAC contractor experience with FISS, MCS and MAS systems. Remote Work Requirements
Wired ethernet connection from router to computer High-speed cable or fiber internet Minimum 10 Mbps downstream and 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 website Compliance & Workplace Information
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 internal policies, including standards for data security, privacy, confidentiality, and program integrity. CMS contractors and personnel are subject to screening and background investigation prior to access to information systems and/or sensitive data.
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