Healthcare Intake & Authorization Specialist - Hybrid/Remote

WPS Health Solutions; Marion (IL); Hybrid; USD 23,000 - 32,000; Full time

Benefits offered by this job

Remote and hybrid work options

Performance bonus

401(k) with strong match

Paid time off

Health insurance

Dental insurance

Telehealth services

Leadership Development Programs

Job summary

WPS Health Solutions is hiring an Intake Specialist to manage inbound and outbound communications, ensuring accurate intake, documentation, and routing of cases. You will support prior authorizations, claims processing, and denials letters while maintaining accuracy and compliance.

You will document interactions in systems, triage cases, and coordinate with clinical staff to ensure timely processing and high-quality service. Hybrid work options and benefits are provided.

Qualifications

• High School Diploma or GED or equivalent experience.
• Two or more years of experience in healthcare, insurance, or medical office environments with communication to providers and patients.
• Working knowledge of medical terminology.
• Strong verbal and written communication with ability to document calls and explain authorization/denial status.
• Ability to multitask and manage high-volume, fast-paced workflows.
• Detail-oriented with strong organizational skills.

Responsibilities

• Serve as first point of contact for inbound/outbound calls and route inquiries.
• Initiate prior authorization cases by collecting demographics and verifying eligibility.
• Accurately document all interactions in the system 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.
• Retrieve and respond to voicemails with timely follow-up.
• Research and resolve inquiries, including risk tasks and service tickets.
• Communicate case updates and coordinate with cross-functional teams.
• Monitor and address audit findings to ensure quality and compliance.

Skills

Healthcare experience

Communication skills

Medical terminology

Documentation ability

Multitasking

Education

High School Diploma or GED

Job description

WPS Health Solutions is hiring an Intake Specialist to manage inbound and outbound communications, ensuring accurate intake, documentation, and routing of cases. You will support prior authorizations, claims processing, and denials letters while maintaining accuracy and compliance.

You will document interactions in systems, triage cases, and coordinate with clinical staff to ensure timely processing and high-quality service. Hybrid work options and benefits are provided.