Healthcare Intake & Authorization Specialist

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

Benefits offered by this job

Remote and hybrid work options

Performance bonus

401(k) with full match on first 3%

Paid time off

Health insurance

Dental and telehealth services

Professional and LeadershipDevelopment

Job summary

WPS, a health solutions company, is seeking an Intake Specialist to manage inbound and outbound communications, document accurately, and route cases within Health Services. You will support prior authorizations, claims processing, and authorization workflows while maintaining high accuracy and customer service standards.

The role offers hybrid work near the Madison, WI area with remote options in approved states, including Virginia.

Qualifications

• Requires High School Diploma or GED.
• 2+ years in healthcare, insurance, or medical office environment; including experience communicating with providers/patients.
• Working knowledge of medical terminology.
• Strong verbal and written communication with accurate documentation of calls and authorization/denial status.
• Ability to multitask and manage high-volume, fast-paced workflows.
• Detail-oriented with strong organizational skills.
• Proficient use of PC and 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.

Skills

Healthcare experience

Medical terminology

Communication skills

Documentation

Multitasking

Attention to detail

PC proficiency

Education

High School Diploma or GED

Job description

WPS, a health solutions company, is seeking an Intake Specialist to manage inbound and outbound communications, document accurately, and route cases within Health Services. You will support prior authorizations, claims processing, and authorization workflows while maintaining high accuracy and customer service standards.

The role offers hybrid work near the Madison, WI area with remote options in approved states, including Virginia.