Healthcare Intake & Authorization Specialist

WPS—A health solutions company; Michigan; Hybrid; USD 23,000 - 32,000; Full time

Benefits offered by this job

Remote/hybrid options

Performance bonus

401(k) with employer match

Paid time off

Health insurance

Telehealth services

Professional development

Job summary

WPS is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations, claims processing and denials letters, with a focus on accuracy and compliance.

The position offers $20.00 per hour, hybrid work 2 days a week near Madison, WI, with remote options in several states. Applicants should have healthcare experience and strong communication skills.

Qualifications

• High School Diploma or GED or equivalent experience.
• Two (2) or more years of experience in healthcare, insurance, or medical office environment; including one (1) 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.
• Ability to multitask and manage high-volume, fast-paced workflows
• Detail-oriented with strong organizational skills
• Proficient use of PC with knowledge of standard software programs.

Responsibilities

• Serve as first point of contact for inbound/outbound calls; gather information and route inquiries appropriately
• Initiate prior authorization cases by collecting demographics and verifying eligibility
• Accurately document all interactions in system(s) within required timeframes
• Triage and assign cases to appropriate clinical staff based on established 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
• Retrieve and respond to voicemails; ensure timely follow-up with providers and customers
• Research and resolve inquiries, including risk tasks and service tickets
• Communicate case updates and coordinate with cross-functional teams
• Monitor and address audit findings; ensure quality and compliance standards are met
• Maintain confidentiality and adhere to all data privacy and security policies
• Support provider registration and system-related processes
• Participate in team meetings, training, and continuous improvement initiatives
• Assist with documentation of procedures and workflow enhancements
• Other job-related responsibilities may be assigned as required

Skills

Healthcare experience

Medical terminology

Verbal and written communication

Documentation in systems

Multitasking

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

WPS is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations, claims processing and denials letters, with a focus on accuracy and compliance.

The position offers $20.00 per hour, hybrid work 2 days a week near Madison, WI, with remote options in several states. Applicants should have healthcare experience and strong communication skills.