Jobs in the United States

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Added just now
CM
Registered Nurse - Oncology Infusion Center
Community Memorial Healthcare
Ventura, CA
- $50 to $78.45 USD / hour
…competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family’s health and…
Added just now
CM
Transporter
Community Memorial Healthcare
Ventura, CA
- $24 USD / hour
…competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family’s health and…
Added just now
I
Chief of Staff
Interlaced
San Diego
- $90,000 to $100,000 USD / year
We have strong professional development pathways throughout the organization. We grow our people.
Added 1 min ago
PH
Pediatric RN Clinical Coordinator -Hospice
ProCare Hospice of Nevada
Las Vegas, NV
- $90,000 to $105,000 USD / year
Must possess a valid RN license with the State of Nevada Boar
Added 1 min ago
Change Manager
Akima, LLC
Portsmouth, NH
Support the design, development, and delivery of change communications to all stakeholders.
Added 1 min ago
Subject Matter Expert
Akima, LLC
Lorton, VA
…role applies highly specialized knowledge to guide complex program and technology initiatives related to the Spectrum Relocation and Video Surveillance Program. The SME advises government…
Added 1 min ago
Director of Business Development
Estes Construction
Des Moines, IA
Work program discounts, employee engagement events, professional training and development
Added 1 min ago
Service Director - BMW of El Cajon
Sunroad Automotive
El Cajon, CA
Provide ongoing coaching, feedback, and development opportunities to improve staff performance.
Added 3 mins ago
BH
Occupational Therapist - Home Health OT
Boost Home Healthcare - Omaha
Omaha, NE
- $48 to $55 USD / hour
Supportive leadership and real‑time assistance in the field
Added 3 mins ago
FK
Shift Supervisor
Five Keys Schools and Programs
Sacramento, CA
- $26 to $28 USD / hour
…and prisons, shelters, permanent supportive housing, and the development of new housing and support programs. At Five Keys, the overarching objective is to uplift individuals and families…
Added 4 mins ago
EF
Vice President, Global Information Technology
Energy Fuels Resources USA Inc
Lakewood, CO
- $175,000 to $190,000 USD / year
…sands assets further supports rare earth processing and the development of products such as titanium, zircon minerals, and medical…
Added 4 mins ago
VP
Program Finance Manager
Votaw Precision Technologies LLC
Santa Fe Springs, CA
- $125,000 to $140,000 USD / year
Deliver monthly program financial reviews to leadership with clear explanations of results and risks.
Added 5 mins ago
NJ
Administrative Specialist 2 (Operations)
New Jersey Courts
Freehold, NJ
- $54,434.49 to $89,181.84 USD / year
…the selected individual will use excellent administrative and leadership skills, strong writing and verbal communication skills, effective multi-tasking, keen attention to detail, and…
Added 5 mins ago
T
Partnerships - Creator Talent
Triumph
San Francisco, CA
- $100,000 to $150,000 USD / year
…through activation, while helping grow our brand ambassador…
Added 5 mins ago
AC
VP Of Finance
Aston Carter
Denver, CO
- $90 to $130 USD / hour
Comfort working onsite in Denver five days per week in a highly collaborative environment
Added 5 mins ago
AC
VP Of Finance
Aston Carter
Portland, OR
- $96.15 to $108.17 USD / hour
Provide leadership, coaching, and mentorship to the finance team, fostering a culture of high performance, continuous improvement, and professional development.
Added 6 mins ago
Software Engineer - Machine Learning
Garmin International, Inc.
Boulder, CO
Participates in project leadership and/or program planning including providing technical input to product development plans and concept documents
Added 6 mins ago
Senior Data Scientist
Garmin International, Inc.
Olathe, KS
…this role, you will be responsible for providing technical leadership and strategic project planning for data science initiatives related to new products, applications, or systems within…
Added 7 mins ago
CC
Manager, Risk Adjustment and Quality Operations
Clever Care Health Plan
Huntington Beach, CA
- $100,000 to $125,000 USD / year
…(RAF), HEDIS, and CAHPS programs through strong operational leadership and provider partnership. This role focuses on building effective relationships with providers, IPAs/MSOs, and…
Added 8 mins ago
MB
Residential Program Manager
Merakey Bucks County
Bensalem, PA
- $30 USD / hour
The Program Manager serves as the leader of a 16-bed Community Residential Rehabilitation (CRR) program in Bensalem, fostering a safe, supportive, and recovery-focused environment where…
Added 8 mins ago
MH
Clinical Nurse II Obstetrics
MedStar Health
Clinton, MD
- $39.42 to $65.17 USD / hour
Demonstrates effective leadership behaviors. Establishes priorities and delegates tasks to peers and ancillary staff as appropriate to scope of practice and unit requirements.
Added 8 mins ago
MH
Clinical Nurse II Special Care Nursery
MedStar Health
Clinton, MD
- $39.42 to $65.17 USD / hour
Demonstrates effective leadership behaviors. Establishes priorities and delegates tasks to peers and ancillary staff as appropriate to scope of practice and unit requirements.
Added 9 mins ago
Associate Talent Development Partner (1450)
HYUNDAI Translead Inc
San Diego, CA
The Associate Talent Development Partner supports the organization's talent development programs (onboarding, compliance, technical, and leadership learning). Delivers and administers…
Added 9 mins ago
JC
Safety Manager/Assistant Safety Director - Swing Shift
Jaquith Consulting Group Inc
New York, NY
- $112,000 to $197,000 USD / year
Set standards for a multibillion-dollar program and lead the development of the safety culture for the program.
Added 9 mins ago
JC
Project Manager - Rail Communications
Jaquith Consulting Group Inc
Sacramento, CA
- $140,000 to $210,000 USD / year
…telecommunications systems on the California High-Speed Rail (CAHSR) Program. The position covers fiber optic backbone networks, operational telecommunications systems, IP/MPLS networks,…

WPS Health Solutions

Claims Representative 2

Denver, CO, United States

$40,123 USD / year

Apply on jobs.connectingcolorado.gov About employer

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Job details

Pay: $40,123 USD / year
Posting language: English
Posted: Nov 13, 2026

Original job description

Description

Role Snapshot The Claims Rep 2 processes Medicare claims from receipt through resolution in accordance with applicable policies, procedures, and regulatory requirements. This role ensures timely and accurate claim resolution while maintaining high standards for quality and customer service.

Hourly Rate of Pay

At least $19.00/hour based on county SCA rates.
On the job training Monday-Friday between 7:30am-4:00pm CT. Cannot miss any time during the training period.
Scheduled Shift: Flexible schedule once trained, 8-hours shifts between 6am-6pm CT.

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

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

Review Medicare Part A and Part B claims including complex and specialty claims, by applying federal and internal guidelines to ensure appropriate application of processing guidelines, payment rules, and manual calculation procedures.
Handle complex adjustments involving multiple admissions and adjustments regarding pending returned notices. Manually adjust reconsideration, including patient complaints and denials, and process through the system accordingly.
Communicate with internal departments, healthcare providers, and members to obtain additional information or clarify claim issues.
Interact with providers by phone to resolve pending claim problems. Correspond with providers, other contractors, and QIOs on various claim-related problems.
Assist department in meeting CMS performance metrics and minimum quality and quantity standards.
Support Claims department and provide back-up for completing staff responsibilities as needed.
Keep up to date with changes in regulations, coding standards, and plan policies.
Meet requirements of Federal Privacy Act, International Organization of Standards (ISO 9000), Freedom of Information, Desk Disclosure Reference, and WPS conflict of interest and confidentiality.

Minimum Qualifications

High School Diploma or GED or equivalent experience.
One (1) or more years of experience in hospital, clinic and/or medical office billing.
One or more years of post-high school education or coursework in insurance or medical-related studies, and experience in a position using computer, keyboarding, and customer communications.
Demonstrated proficiency in data entry with a strong ability to maintain focus and accuracy.
Ability to multitask, prioritize, problem-solve, and effectively adapt to a fast-paced environment.
Ability to work independently and meet quality and production standards.

Preferred Qualifications

Previous health/Medicare adjudication experience preferred.
Experience with UB/institutional (CMS-1450) and HCFA/professional (CMS-1500) claims preferred.
Familiarity with medical terminology, procedure and diagnosis codes preferred.

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).
Please review Remote Worker FAQs for additional information.
Remote 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
Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

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 organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.

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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 DisabilitiesThis employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer. Apply at: https://ipc.us/t/72588091B4A44F5C.

Apply on jobs.connectingcolorado.gov About employer

More about this job

Skills

CMS
Data entry
Multitask
Work independently
Medical terminology

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Work requirements

Jobs in the United States