Payment Records Adjuster

WPS Health Solutions • Madison, WI • 1d ago

JOB REQUIREMENTS: Description U.S. Citizenship is required for this
position due to Department of Defense restrictions. Correct payment
errors on a post-processing basis, including credits, additional
payments, statistical adjustments, recoupments, correspondence, and
patient or sponsor updates.Must live within 45 miles of WPS Corporate
Center Building (1717 W. Broadway) in Madison, WI 53713 Additional
Information Start Date: 8/23/26 Starting Base Salary: At least \$17.75
Training Location/Schedule: On the job Training Monday-Friday core hours
between 6:00am CT and 4:00pm CT Scheduled Shift: Flexible schedule once
trained, 8-hours shifts between 6am-10pm Work Location: Remote and
onsite options are available. How do I know this opportunity is right
for me? If you: Have processed adjustments according to TRICARE Policy
by making an additional payment, reissue, or statistical adjustment.
Like to identify and credit refunds to correct claim history. Contact
beneficiaries, providers, and other agencies as necessary to obtain
information to ensure refunds are posted to correct account. Can request
recoupment of payments in accordance with TRICARE Policy and Operational
Manual. Enjoy responding to correspondence from internal and external
customers to include departments within MVH Division, attorneys,
insurance companies, TRICARE Management Activity (TMA), government
agencies, and prime contractors. Can coordinate benefits with commercial
insurance, Medicare, and other plans. Like to review computer generated
and inventory reports to prioritize workflow to ensure claims processing
timeline standards are met. Have reported aging inventory concerns or
system issues to supervisor or unit coordinator. Enjoy processing
adjustments and credits with an understanding of TRICARE Encounter Data
editing requirements imposed by TMA. Like to review claims to determine
if processing is correct according to automated claims processing
system\'s methodology for pricing, reimbursement, and cost-sharing. Have
interpreted legal documents for payments involving judgments such as
custodial or bankruptcy. Enjoy making recommendations for process
improvements by filing an Improvement Corrective Preventative Action
(ICPA) and Potential Non-Conformance (PNC) forms. Can complete Sponsor
Patient Information Updates (SPIU) accordingly. Minimum Qualifications
U.S. Citizenship is required for this position due to Department of
Defense restrictions. High school diploma or equivalent. 1 or more years
recent TRICARE claims entry (claims support) or processing OR 2 or more
years office experience involving account reconciliations and customer
contact including bookkeeping, billing, or financial services. Possess
data entry and 10-key skills Ability to learn and apply TRICARE
benefits,... 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/8878C203E6BC4E7E Qualified females, minorities, and special
disabled veterans and other veterans are encouraged to apply.

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