Intake Specialist

WPS Health Solutions; Madison (WI); Hybrid; USD 23,000 - 32,000; Full time

Benefits offered by this job

401(k) match

Health insurance

Paid time off

Remote/hybrid options

Job summary

WPS Health Solutions in Madison, WI seeks an Intake Specialist to manage inbound/outbound calls, collect demographics, verify eligibility, and document all interactions in the system with accuracy. You will triage cases, support prior authorizations, and process claims and appeals within defined timelines.

The role requires multitasking in a fast-paced healthcare environment, strong communication, and attention to detail.

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.

Responsibilities

• 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

Skills

Healthcare experience

Communication skills

Multitasking

Detail-oriented

Analytical thinking

Proficient PC skills

Education

High School Diploma or GED

Tools

Microsoft Office

EMR systems

Job description

Role Snapshot The Intake Specialist manages inbound and outbound communications for Health Services, ensuringaccurateintake,documentationand routing of cases. This role supports prior authorizations, claims processing including writing authorization and denial letters, case setup, and triage of tasks whilemaintaininghigh standardsof accuracy,complianceand 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:

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 youenjoy 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 requiredtimeframes
• 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; ensuretimelyfollow-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
• Assistwith documentation of procedures and workflow enhancements
• Other job-related responsibilities may be assigned asrequired

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 ).
• 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% vestedimmediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs

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,seniorsand 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-dutyand retired militarypersonnel across the U.S. and abroad. WPS has been making healthcare easier for the people we servefor nearly 80 years . Proud to be military and veteran ready.

Culture Drives Our Success WPS’ culture is where thegreat workand innovations of our people are seen,fueledand rewarded. Weaccomplishthis 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 effectivelyseek,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.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.