Intake Specialist

WPS—A health solutions company; Indiana (PA); Hybrid; USD 25,000 - 30,000; Full time

Benefits offered by this job

Remote and hybrid options

Performance bonus or merit increase

401(k) with match

Health/dental/telehealth start day 1

Professional development programs

Job summary

WPS—A health solutions company is seeking an Intake Specialist to manage inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. You will support prior authorizations, claims processing and triage of tasks with a focus on accuracy and compliance.

The position offers a $20.00/hour pay and hybrid work 2 days per week for nearby employees, with remote options in many states.

Qualifications

• Two or more years in healthcare, insurance, or medical office settings.
• Experience communicating with providers and patients.
• Ability to document calls accurately and within required timelines.
• Ability to triage and route inquiries to clinical staff.

Responsibilities

• 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 the 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.
• Retrieve voicemails and ensure timely follow-up with providers and customers.
• Research and resolve inquiries, including risk tasks.
• Communicate case updates and coordinate with cross-functional teams.
• Monitor audit findings and ensure quality and compliance.
• Maintain confidentiality and adhere to data privacy policies.
• Support provider registration and system-related processes.
• Participate in training and continuous improvement initiatives.
• Assist with documentation of procedures and workflow enhancements.
• Other duties as required.

Skills

Verbal and written communication

Medical terminology

Multitasking

Attention to detail

Analytical thinking

PC proficiency

Documentation skills

Education

High School Diploma or GED

Job description

Role Snapshot

The Intake Specialist manages inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. This role supports prior authorizations, claims processing including writing authorization and denial letters, case setup, and triage of tasks while maintaining high standards of accuracy, compliance and customer service.

Role Snapshot

The Intake Specialist manages inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. This role supports prior authorizations, claims processing including writing authorization and denial letters, case setup, and triage of tasks while maintaining high standards of accuracy, compliance and customer service.

Hourly Rate of Pay

$20.00/hour. Pay may fluctuate based on experience.

Work Location

Employees within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to be able to be able to work Hybrid 2 days a week on a regular basis.

As a secondary consideration, we do offer remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

We are open to remote work in the following approved states:

Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

How do I know this opportunity is right for me? If you enjoy the following:

• 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
• Maintain confidentiality and adhere to all 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

Minimum Qualifications

• High School Diploma or GED or equivalent experience.
• Two (2) or more years of experience in healthcare, insurance, or medical office environment; including one (1) or more years communicating with providers and patients
• Working knowledge of medical terminology
• Strong verbal and written communication skills with ability to accurately document calls and explain requirements in the determination of 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.

Remote Work Requirements

• High speed cable or fiber internet.
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
• Please review Remote Worker FAQs for additional information.

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce - both current and future - to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.