Our Medicare Appeals Manager (HH & H - Home Health and Hospice) oversees the first-level appeals processes this includes investigations, resolutions, documentation, and follow-up in alignment with regulatory standards. They ensure timely, accurate reporting of Medicare Administrative Contractor (MAC) deliverables and supports process improvements through trend analysis. This Medicare Appeals Manager monitors departmental performance, ensures CMS (Center for Medicare and Medicaid Services) compliance, and collaborates with internal teams to optimize outcomes. Serves as a key liaison with CMS and internal stakeholders to support operational efficiency and regulatory compliance within the Home Health and Hospice services.
\nSalary Range
90,000 ~120,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.
Work Location
We are open to remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you:
Minimum Qualifications
\nPreferred Qualifications
\nRemote Work Requirements
\nBenefits
\nWho We Are
\nWPS, 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.
\nCulture Drives Our Success
\nWPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
\nWe are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
\n\nFOLLOW US!
Instagram
LinkedIn
Facebook
WPS Health Blog
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 but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.
This offer from \"WPS Health Solutions\" has been enriched by Jobgether.com and got a 76% flex score.","identifier":{"@type":"PropertyValue","name":"WPS Health Solutions","value":"6408f862316d2b3324cd7e1c"},"hiringOrganization":{"@type":"Organization","name":"WPS Health Solutions","sameAs":"https://www.wpshealthsolutions.com/","logo":"https://cdn-s3.jobgether.com/wpshealthsolutions/profile.webp"},"datePosted":"Thu Aug 14 2025 01:31:12 GMT+0000 (Coordinated Universal Time)","employmentType":["FULL_TIME"],"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":[{"@type":"Country","name":"US"}],"jobLocation":[{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Payson","addressCountry":"US"}}],"validThrough":"2026-08-09T01:31:12.613Z"}Role Snapshot
Our Medicare Appeals Manager (HH & H - Home Health and Hospice) oversees the first-level appeals processes this includes investigations, resolutions, documentation, and follow-up in alignment with regulatory standards. They ensure timely, accurate reporting of Medicare Administrative Contractor (MAC) deliverables and supports process improvements through trend analysis. This Medicare Appeals Manager monitors departmental performance, ensures CMS (Center for Medicare and Medicaid Services) compliance, and collaborates with internal teams to optimize outcomes. Serves as a key liaison with CMS and internal stakeholders to support operational efficiency and regulatory compliance within the Home Health and Hospice services.
Salary Range
90,000 ~120,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.
Work Location
We are open to remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you:
Minimum Qualifications
Preferred Qualifications
Remote Work Requirements
Benefits
Who We Are
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.
Culture Drives Our Success
WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
FOLLOW US!
Instagram
LinkedIn
Facebook
WPS Health Blog
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 but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.
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