WI3647068

1

High School Diploma/GED

High School Diploma/GED Equivalent

Unspecified

20

JOB REQUIREMENTS: Description Who We Are 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
more than . 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
inclusive and empowering employee experience. We recognize the benefits
of Diversity, Equity, and Inclusion as an investment in our
workforce-both current and future-to effectively seek, leverage, and
include diverse 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. From 2021 to 2023, WPS Health
Solutions was recognized for several awards: Role Snapshot The Provider
Certification Analyst position will assist in maintenance of TRICARE
Provider File online system, including determination of provider
certification, eligibility and network status, and ensure accuracy for
TRICARE National provider file shared by all TRICARE offices. In this
role you will: Perform data Entry into online internal provider file.
Resolve issues via phone, internet or correspondence. Respond to
questions and problems through phone calls and written correspondence.
Initiate telephone calls to obtain additional information to resolve
certification issues. Validate, through research, all data entered into
online system is accurate for claims processing. Identify claims
processed erroneously and initiate appropriate reprocessing steps.
Verify eligibility of providers. Maintain understanding of claim edits,
entry, and enter information to correct edits, allowing claims to
process. Assign provider number for claims processing. Research
jurisdiction and multiple files to determine status and ensure related
claims or issues are addressed. Work with various internal departments
regarding file content to pay or deny claims and verification of
addresses. Resolve special handle issues, claims, or projects as
assigned by management. Detect online system issues or deficiencies and
notify supervisor, researching and providing documentation. How do I
know this opportunity is right for me? If you: Are able to navigate
multiple systems and on-line resources to\... For full info follow
application link. Wisconsin Physicians Service Insurance Corporation is
an Equal Opportunity Employer/Protected Veterans/Individuals with
Disabilities employer. \*\*\*\*\* APPLICATION INSTRUCTIONS: Apply
Online: ipc.us/t/530F70D32550462E Qualified females, minorities, and
special disabled veterans and other veterans are encouraged to apply.