Care Access Intake Specialist — Hybrid/Remote

WPS Health Solutions; Kansas City (MO); Hybrid; USD 23.000 - 32.000; Vollzeit

Benefits dieser Stelle

Remote and hybrid options

Performance bonus/merit increases

401(k) with match (100% vested)

Paid time off

Health and dental insurance; telehealh

Professional and leadershipdevelopment

Zusammenfassung

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. You will support prior authorizations, claims processing, and drafting approval/denial letters while maintaining compliance and high-quality customer service.

The role requires attention to detail, strong communication skills, and the ability to document interactions in our systems.

Qualifikationen

• Two or more years of experience in healthcare, insurance, or medical office environment; including one or more years communicating with providers and patients.
• Working knowledge of medical terminology.
• Strong verbal and written communication skills with ability to accurately document calls and explain requirements in the determination of authorization status or claim denials.

Aufgaben

• Serve as first point of contact for inbound/outbound calls and route inquiries.
• Initiate prior authorization cases by collecting demographics and verifying eligibility.
• Document all interactions in systems within required timeframes.
• Triage and assign cases to appropriate clinical staff based on guidelines.
• Index and manage clinical documentation within authorization platforms.
• Process claims and support appeals and authorization workflows.
• Draft and issue approval/denial letters within defined timelines.
• Retrive voicemails and ensure timely follow-up with providers and customers.
• Communicate case updates and coordinate with cross-functional teams.
• Monitor and address audit findings to ensure quality and compliance.

Kenntnisse

Healthcare experience

Medical terminology

Communication

Multitasking

Detail orientation

Analytical thinking

PC proficiency

Ausbildung

High School Diploma or GED

Jobbeschreibung

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. You will support prior authorizations, claims processing, and drafting approval/denial letters while maintaining compliance and high-quality customer service.

The role requires attention to detail, strong communication skills, and the ability to document interactions in our systems.