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Medicare Outreach and Education Specialist (HH & H)

Medicare Outreach and Education Specialist (HH & H)

WPS-A health solutions companyOrlando, FL, US
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Overview

Medicare Outreach and Education Specialist (HH & H) 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 role 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. The 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.

Responsibilities

  • Develop educational materials and presentations for Medicare provider education on current and upcoming CMS regulations.
  • Host events and coordinate training sessions, workshops, and training materials tailored to provider needs.
  • Analyze data (error data, geographic data, regulatory changes) to identify education needs and opportunities to reduce billing errors.
  • Collaborate with internal teams (Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to communicate issues to Provider Outreach & Education staff.
  • Establish and maintain a POE Advisory Group (POE AG) to assist contractors in 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.
  • 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., YouTube Channel, WebEx, 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 is approximately 15% in the future.
  • Preferred Qualifications

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

  • 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. (Can be checked at speedtest.net)
  • Please 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 insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits : https : / / www.wpshealthsolutions.com / careers / fulltime_benefits.shtml
  • About Us

    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.

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