Intake Specialist

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. Work Location 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 - 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 {=html} - 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. {=html} - 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. {=html} - 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 co