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.
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 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.
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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.
Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.
