Medicare File Coordinator

JOB REQUIREMENTS: Description Role Snapshot Our Medicare FileCoordinator coordinates and performs maintenance and testing as requiredby policy changes, Shared System Maintainer mandates, or Centers forMedicare and Medicaid Services (CMS) directives within specifiedtimeframes. This includes updating and maintaining system files toreport and test issues. Research and provide written responses tointernal and external customer inquiries or system issues pertaining toShared System or files. Researches and responds to interdepartmentalreferrals, reviews and updates processes and coding guidelines foraccuracy and effectiveness. Salary Range $44,000-53,700 annually Thebase pay offered for this position may vary within the posted rangebased on your job-related knowledge, skills and experience. We are opento remote work in the following approved states: Arizona, Colorado,Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota,Missouri, Nebraska, Nevada, New Jersey, North Carolina, Ohio, SouthCarolina, Texas, Virginia, Wisconsin In this role, you will: CompleteCenters for Medicare and Medicaid Services (CMS) Change Requests toimplement required changes/enhancements. Requesting, validatingmaintenance, performing maintenance, System Control Facility coding,testing, validation of testing/coding, annual profile build, andassuring system accuracy. Maintain documentation. Download, verify, andinstall Centers for Medicare and Medicaid Services update files asdirected. Write, test, and cross copy ECPS events for Claims Processing.Maintain Healthcare Integrated General Ledger Accounting System. ConductCEM and IVR patch testing. Validate changes in the Direct Data EntrySystem. Prepare Maintenance Request forms and perform manual systemmaintenance to load files and updates that cannot be systematicallyinstalled. Provide Fee Schedule Disclosures and pricing articles.Review, analyze, and provide contractor feedback. Review, analyze, andtest a variety of applications on mainframe and Personal Computer base.Retain, review, compile and submit information needed for support oflitigations. Provide technical expertise in interpretation of issuesrelating to Medicare regulations and claims processing. Prepare andissue notices to inform, educate, or alert operations and customerservice areas when systems issues have been identified. Develop excelbased worksheets to assist in manual pricing calculations andverification of CMS pricing files. Perform processing guideline updatesand/or request coding changes for the Targeted Probe and Educate (TPE)audits as needed. Develop skills to request maintenance to updateinternal coding and processing guidelines for MCS and FISS. Attend andactively participate in weekly Functional Workgroup (FWG)... For fullinfo follow application link. Wisconsin Physicians Service InsuranceCorporation is an Equal Opportunity Employer/ProtectedVeterans/Individuals with Disabilities employer. APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/A71B0C0548664248 Qualified females,minorities, and special disabled veterans and other veterans areencouraged to apply.

Created: 2025-11-15