Healthcare Intake & Authorization Specialist (Hybrid/Remote)

WPS Health Solutions; Monona (WI); Hybrid; USD 23.000 - 32.000; Vollzeit

Benefits dieser Stelle

Remote and hybrid work options

Performance bonus and merit increases

401(k) with 100% match for the first 3

Competitive PTO

Health, dental, and telehealth fromDAY

Zusammenfassung

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, support prior authorizations and claims processing, and ensure accurate intake and documentation. You will triage tasks, draft letters, and maintain compliance while delivering excellent customer service.

This role requires attention to detail, the ability to multitask in a fast-paced healthcare setting, and strong written and verbal communication.

Qualifikationen

• Two or more years in healthcare, insurance, or medical office environments.
• Experience communicating with providers and patients.
• Working knowledge of medical terminology.
• Ability to document calls accurately and explain authorization/denial status.
• Ability to multitask in a fast-paced environment.
• Proficient use of a PC and standard software.

Aufgaben

• Serve as the 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 system(s) 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.
• Respond to voicemails and coordinate timely follow-up with providers and customers.
• Research and resolve inquiries, including risk tasks and service tickets.
• Communicate case updates and collaborate with cross-functional teams.

Kenntnisse

Healthcare experience

Medical terminology

Verbal communication

Written communication

Multitasking

Detail oriented

Ausbildung

High School Diploma or GED

Jobbeschreibung

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, support prior authorizations and claims processing, and ensure accurate intake and documentation. You will triage tasks, draft letters, and maintain compliance while delivering excellent customer service.

This role requires attention to detail, the ability to multitask in a fast-paced healthcare setting, and strong written and verbal communication.