Medical Management Intake Specialist

at WPS Health Solutions in Marion, Illinois, United States

Job Description


Who We Are
WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in 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 Health Solutions has been making health care easier for the people we serve for more than 75 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 inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse 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
Role Snapshot
As the Medical Management Intake Specialist, you'll handle customer and provider inquiries about preauthorization requests. This includes initiating the process by gathering demographic information and verifying eligibility. You'll also be responsible for communicating case details to internal departments and utilizing various systems for effective case management. Additionally, you'll generate letters and leverage conditional formatting to conduct initial case screenings.
How do I know this opportunity is right for me? If you:
Enjoy working with members, providers, and internal staff regarding the status of prior authorizations and pended claims or Customer Service (CS) tasks.
Have experience working with providers and patients in a health insurance customer service, claims processing or medical office.
If you demonstrate strong verbal communication and analytical skills with the ability to effectively communicate to internal and external customers while promoting usage of our electronic medical record submission process
Enjoy navigating through multiple systems
What will I gain from this role?
You will gain a deep understanding of the processes involving pre-approval of medical services allowing customers to have awareness of their financial responsibility in advance of a procedure being performed.
Experience working in a fast pace and changing environment that focuses on superior customer service and teamwork.
The opportunity to improve processes that will allow greater efficiency and customer satisfaction.
Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries
Working in a continuous performance feedback environment.
Minimum Qualifications
High School Diploma or equivalent
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
Please review Remote Worker FAQs for additional information
Hourly Rate of Pay
Starting rate of at least $20/hour
Work Location
We are a remote-first organization and offer remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin
To help strengthen communication, provide a sense of community, and improve the overall remote work experience, the assigned office community based on the position's division is: Green Bay, Wisconsin
Remote work
Performance bonus and/or merit increase opportunities
401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start DAY 1
Employee Resource Groups
Professional and Leadership Development Programs
Review additional benefits here
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have... For full info follow application link.

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

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Job Posting: 11915942

Posted On: May 20, 2024

Updated On: Jun 08, 2024

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