Payment Records Adjuster (Claims Support Specialist

Job Category: Claims Processing

Requisition Number: PAYME
006145

• Posted :
  July 27, 2026
• Full-Time

Showing 1 location

Corporate Center
1717 W Broadway
Madison, WI 53713, USA

Corporate Center
1717 W Broadway
Madison, WI 53713, USA

U.S. Citizenship isrequiredfor 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 jobTraining
  
  Monday-Fridaycore 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 processedadjustments according to TRICARE Policy by makinganadditionalpayment, reissue, or statistical adjustment.
• Like toidentifyand 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 requestrecoupment of payment sin accordance withTRICARE 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.
• Havereportedaging inventory concerns or system issues to supervisor or unit coordinator.
• Enjoy processingadjustments and credits with an understanding of TRICARE Encounter Data editing requirements imposed by TMA.
• Like to review claims todetermineif processing is correct according to automated claims processing system’smethodologyfor pricing, reimbursement, and cost-sharing.
• Have interpretedlegal documents for payments involving judgments such as custodial or bankruptcy.
• Enjoymakingrecommendations 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 isrequiredfor 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, Policy, Operations Manual, and federal regulations.
• Ability to learn TRICARE claims processing methodologies and systems in resolution of payment errors.
• Ability to interpret legal documents and documents from primary insurance.

Remote Work Requirements

• Wired (ethernet cable) 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 internet connection (can be checked at  ).
• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Employee Resource Groups
• Professional and Leadership Development Programs

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-dutyand retired military…