Benefits at WPS Health Solutions

Support ITIL-based infrastructure processes including change control in ServiceNow, attend Change Advisory Board meetings, update and test documentation, assist disaster recovery planning, and help with major incident and problem management activities while collaborating with cross-functional teams.

Review and adjudicate first‑level Medicare redetermination appeals by comparing claims to audits and policy, reviewing medical documentation, referring clinical cases, drafting MRN letters, resolving coding/payment errors, documenting actions, educating providers, and supporting CMS performance metrics.

Prepare and reconcile general ledger entries, perform cost allocations and government receipt reconciliations, respond to internal and external inquiries, support budgeting and financial planning, and drive process improvements to ensure accurate financial reporting across business lines.