Health Services Intake Specialist – Remote eligible after onsite training

🔥 7 minutes ago

🌾 Iowa – Remote

🌾 Iowa – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Wellmark Blue Cross and Blue Shield

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1939

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Wellmark Blue Cross and Blue Shield is a health insurance provider operating primarily in Iowa and South Dakota. The company offers a range of health insurance plans including individual and family plans, Medicare Advantage, Medicare Supplement, and employer group plans. Wellmark emphasizes providing coverage options that meet diverse needs and budgets, and offers resources for managing accounts, payments, and health care access through their online portal, myWellmark. Additionally, Wellmark provides resources for providers, employers, and producers to drive business efficiency and quality in health care services.

📋 Description

• Facilitate care management functions in a call center setting • Verify member eligibility and benefits • Verify provider participation and network status • Process eligibility, authorization status inquiries, data collection, documentation, precertification, and notification requests • Provide administrative support to care management teams • Document information received by phone, fax, or provider portal in JIVA • Manually create episodes for services and admissions for Nurse Care Manager medical-necessity review • Create and send letters to providers and members communicating authorization request outcomes • Manage workload within regulatory turnaround requirements and mandated processing timeframes • Provide accurate information using current guidelines and job aids • Meet Health Services quality assurance and production metrics • Interpret and comply with regulatory, accreditation, HIPAA, Health Services, and internal standards • Perform other duties as assigned

🎯 Requirements

• High School Diploma or GED • 1+ years of related experience, including customer or provider service experience • Experience developing customer relationships via telephone • Experience obtaining necessary information and accurately documenting conversations • Health insurance or health care industry experience • Experience working within a production environment with production and quality metrics • Demonstrated ability to apply critical thinking to resolve issues and conflicts while maintaining composure and confidence • Ability to prioritize work and meet deadlines • Strong written and verbal communication skills • Proficiency with Microsoft Office applications • Excellent attendance and punctuality • Comfortable working in a high-volume, fast-paced call center environment • Must not require immigration sponsorship or additional/permanent work authorization now or in the future to work in the United States

🏖️ Benefits

• Remote work eligibility after successful six-week onsite training • Option to work fully remote each weekday or follow a hybrid office/home schedule • Option to come into a Wellmark office depending on location • Occasional office attendance for specific meetings or other “moments that matter” • Reasonable accommodation support for applicants with disabilities • Responsible use of AI tools welcomed during the application process