Hybrid Healthcare Intake & Authorization Specialist

WPS Health Solutions; Indianapolis (IN); Hybrid; USD 40,000 - 46,000; Full time

Benefits offered by this job

Remote and hybrid work options

Performance bonus

401(k) with match

Health insurance, dental, telehealth (

Paid time off

Professional development

Job summary

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations, claims processing and drafting authorization/denial letters.

The position emphasizes accuracy, compliance and exceptional customer service within a hybrid work arrangement. Indiana-based candidates are preferred, with remote options in approved states.

Qualifications

• High School Diploma or GED or equivalent experience.
• 2+ years in healthcare, insurance, or medical office environment; including 1+ year communicating with providers and patients.
• Working knowledge of medical terminology.
• Strong verbal and written communication; able to document calls and explain authorization status or claim denials.
• Ability to multitask and manage high-volume, fast-paced workflows.
• Detail-oriented with strong organizational skills.
• Analytical thinking and problem-solving capability.
• Proficient use of PC with knowledge of standard software programs.

Responsibilities

• Serve as the first point of contact for inbound/outbound calls; gather information and route inquiries.
• Initiate prior authorization cases by collecting demographics and verifying eligibility.
• Accurately document all interactions in systems 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; 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.
• Maintain confidentiality and adhere to 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.
• Other job-related responsibilities may be assigned as required.

Skills

Communication

Multitasking

Detail-oriented

Analytical thinking

Written communication

Medical terminology

PC literacy

Education

High School Diploma or GED

Job description

WPS Health Solutions is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations, claims processing and drafting authorization/denial letters.

The position emphasizes accuracy, compliance and exceptional customer service within a hybrid work arrangement. Indiana-based candidates are preferred, with remote options in approved states.