Healthcare Intake Specialist — Hybrid/Remote

WPS Health Solutions; Newark (NJ); A distancia; USD 23.000 - 32.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote and hybrid work options

Performance bonus

401(k) with matching

Health insurance from DAY 1

Professional development programs

Paid time off

Descripción de la vacante

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, ensure accurate intake, and route cases for prior authorizations and claims processing. You will document interactions, triage tasks, and support authorization workflows with a focus on accuracy and compliance.

Responsibilities include drafting approval/denial letters, coordinating with clinical staff, and maintaining confidentiality in a fast-paced health services environment.

Formación

• Strong verbal and written communication skills.
• Ability to multitask and manage high-volume, fast-paced workflows.
• Detail-oriented with strong organizational skills.
• Analytical thinking and problem-solving capability.

Responsabilidades

• 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.

Conocimientos

Verbal communication

Written communication

Multitasking

Detail-oriented

Analytical thinking

Educación

High School Diploma or GED

Herramientas

PC proficiency

Descripción del empleo

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications, ensure accurate intake, and route cases for prior authorizations and claims processing. You will document interactions, triage tasks, and support authorization workflows with a focus on accuracy and compliance.

Responsibilities include drafting approval/denial letters, coordinating with clinical staff, and maintaining confidentiality in a fast-paced health services environment.