Hybrid Healthcare Intake Specialist: Auth & Claims

WPS—A health solutions company; Madison (WI); Hybrid; USD 23.000 - 32.000; Vollzeit

Benefits dieser Stelle

Remote and hybrid work options

Performance bonus or merit increases

401(k) with company match

Competitive PTO

Health/dental/telehealth from Day 1

Professional and Leadership Programs

Zusammenfassung

WPS, a health solutions company, is seeking an Intake Specialist to manage inbound and outbound communications, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations and claims processing, including drafting letters and triage of tasks with a focus on accuracy and compliance.

The position is hybrid, based near Madison, WI, with remote options in approved states.

Qualifikationen

• Two or more years in healthcare, insurance, or medical office environments.
• Strong verbal and written communication; ability to document calls and explain requirements.
• Proficient use of PC with standard software programs.
• Detail-oriented with strong organizational skills.
• Analytical thinking and problem-solving capability.

Aufgaben

• Serve as 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 within required timeframes.
• Triage and assign cases to appropriate clinical staff.
• 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.
• Communicate case updates and coordinate with cross-functional teams.
• Monitor audit findings and maintain quality and compliance standards.
• Maintain confidentiality and adhere to data privacy policies.

Kenntnisse

Healthcare experience

Communication skills

Medical terminology

Documentation

Multitasking

Data entry

Ausbildung

High school diploma or GED

Jobbeschreibung

WPS, a health solutions company, is seeking an Intake Specialist to manage inbound and outbound communications, ensuring accurate intake, documentation and routing of cases. The role supports prior authorizations and claims processing, including drafting letters and triage of tasks with a focus on accuracy and compliance.

The position is hybrid, based near Madison, WI, with remote options in approved states.