Medicare Outreach & Education Specialist

Overview

Role Snapshot The Medicare Outreach & Education Specialist plays a crucial role in our Medicare Program by 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, all while working in a fast-paced, remote environment. This education is provided to Medicare providers, coders, billers, and compliance staff to help them understand the Medicare program and be informed about changes.

The role assists providers in developing best practices to avoid coverage and billing errors to reduce error rates and protect the Medicare Trust Fund. The Outreach and Education Specialist focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders.

• Develop and deliver educational content to the provider community regarding current and upcoming CMS regulations.
• Create and develop educational materials, host events, and analyze data to improve provider education and reduce billing errors.
• Provide education to Medicare providers, coders, billers, and compliance staff to help them understand the Medicare program and changes.
• Assist providers in developing best practices to avoid coverage and billing errors, reducing error rates, and protecting the Medicare Trust Fund.
• Focus on a positive customer experience through relationship building with providers, CMS, and stakeholders.
• Coordinate with internal teams (e.g., Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to ensure issues are communicated and shared with POE staff.
• Establish and maintain a POE Advisory Group to assist contractors in creation, implementation, and review of provider education strategies and efforts.

• 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 and understanding of medical billing, coding, and insurance processes.
• Proficient with Microsoft Office Suite and using various modes of technology to deliver training (i.e., You Tube Channel, Web Ex, etc.).
• Excellent written and verbal communication skills with the ability to present complex information clearly and effectively to diverse audiences.
• Strong interpersonal and relationship-building skills.
• Ability to travel for onsite training and education sessions – travel will be approximately 15% in the future.

• CMS knowledge of the Home Health and Hospice program.
• Strong facilitation, presentation and training experience to large groups.
• MAC contractor experience with FISS, MCS and MAS systems.

• 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
• Please review Remote Worker FAQs for additional information

Salary Range $60,000 - $95,000

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

• 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 insurance, dental insurance, and telehealth services start day 1
• Professional and Leadership Development Programs
• Review additional benefits:

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.

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 standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background…