Healthcare Intake & Authorization Specialist (Hybrid/Remote)

WPS Health Solutions; Omaha (NE); Hybrid; USD 25,000 - 30,000; Full time

Benefits offered by this job

Remote/hybrid options

Bonus opportunities

401(k) match

Paid time off

Health insurance

Development programs

Job summary

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, support prior authorizations, and process claims with a focus on accuracy and compliance. The role offers hybrid work within 45 miles of Madison, WI, with remote options in selected states.

The ideal candidate will have 2+ years in healthcare or medical office settings, strong communication skills, and proficiency with standard software. Apply to join a mission-driven not-for-profit health insurer.

Qualifications

• 2+ years in healthcare, insurance, or medical office environment.
• Proficient use of medical terminology.
• Strong verbal and written communication with ability to document calls clearly.

Responsibilities

• Serve as first point of contact for inbound/outbound calls and route inquiries.
• Initiate prior authorization by collecting demographics and verifying eligibility.
• Document interactions in systems within required timeframes.
• Triage and assign cases to 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 voicemails and ensure timely follow-up with providers and customers.
• Research and resolve inquiries, including risk tasks and service tickets.
• Coordinate with cross-functional teams and monitor audit findings.

Skills

Healthcare terminology

Verbal and written communication

Multitasking

Detail oriented

Analytical thinking

Proficient PC skills

Education

High School Diploma or GED

Job description

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, support prior authorizations, and process claims with a focus on accuracy and compliance. The role offers hybrid work within 45 miles of Madison, WI, with remote options in selected states.

The ideal candidate will have 2+ years in healthcare or medical office settings, strong communication skills, and proficiency with standard software. Apply to join a mission-driven not-for-profit health insurer.