Health Services Intake Specialist – Remote eligible after onsite training

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Facilitate care management activities within a call center environment.

• Confirm member eligibility and benefits.

• Verify provider participation and network affiliation.

• Handle inquiries regarding eligibility, authorization status, data collection, documentation, precertification, and notification requests.

• Provide administrative assistance to care management teams.

• Record information received via phone, fax, or provider portal in JIVA.

• Manually generate episodes for services and admissions for Nurse Care Manager review based on medical necessity.

• Compose and dispatch letters to providers and members regarding the outcomes of authorization requests.

• Manage workload in accordance with regulatory turnaround requirements and mandated processing timelines.

• Deliver accurate information in line with current guidelines and job aids.

• Achieve Health Services quality assurance and production targets.

• Interpret and adhere to regulatory, accreditation, HIPAA, Health Services, and internal standards.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or GED is required.

• Over 1 year of related experience, encompassing customer or provider service.

• Experience in fostering customer relationships over the phone.

• Proven ability to gather necessary information and accurately document discussions.

• Background in the health insurance or healthcare industry.

• Experience in a production-oriented environment with set production and quality standards.

• Ability to apply critical thinking in resolving issues and managing conflicts with composure and confidence.

• Strong prioritization skills to manage workload and meet deadlines.

• Excellent written and verbal communication abilities.

• Proficiency in Microsoft Office applications.

• Consistent attendance and punctuality are essential.

• Comfortable working in a high-volume, fast-paced call center setting.

• Must not require immigration sponsorship or additional/permanent work authorization now or in the future to work in the United States.

🏝️ Benefits

• Eligibility for remote work following successful six-week onsite training.

• Flexibility to work fully remote each weekday or adopt a hybrid office/home schedule.

• Option to visit a Wellmark office depending on your location.

• Occasional office presence for specific meetings or important events.

• Support for reasonable accommodations for applicants with disabilities.

• Encouragement of responsible use of AI tools during the application process.