Description Role SnapshotThe 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 LocationEmployees 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, WisconsinHow 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 appropriatelyInitiate prior authorization cases by collecting demographics and verifying eligibilityAccurately document all interactions in system(s) within required timeframesTriage and assign cases to appropriate clinical staff based on established guidelinesIndex and manage clinical documentation within authorization platformsProcess claims and support appeals and authorization workflowsDraft and issue approval/denial letters within defined timelinesRetrieve and respond to voicemails; ensure timely follow-up with providers and customersResearch and resolve inquiries, including risk tasks and service ticketsCommunicate case updates and coordinate with cross-functional teamsMonitor and address audit findings; ensure quality and compliance standards are metMaintain confidentiality and adhere to all data privacy and security policiesSupport provider registration and system-related processesParticipate in team meetings, training, and continuous improvement initiativesAssist with documentation of procedures and workflow enhancementsOther job-related responsibilities may be assigned as requiredMinimum QualificationsHigh 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 patientsWorking knowledge of medical terminologyStrong 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 workflowsDetail-oriented with strong organizational skillsAnalytical thinking and problem-solving capabilityProficient use of PC with knowledge of standard software programs.

Remote Work RequirementsHigh 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. BenefitsRemote and hybrid work options availablePerformance bonus and/or merit increase opportunities401(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 offHealth insurance, dental insurance, and telehealth services start DAY 1Professional and Leadership Development ProgramsReview additional benefits: (https://www.wpshealthsolutions.com/careers/) Who We AreWPS, 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 SuccessWPS' 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. Sign up for Job Alerts

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!InstagramLinkedInFacebookWPS Health Blog Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThis 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.