Intake Solutions Specialist - Remote

Overview

Humata Health is seeking an Intake Solutions Specialist who supports the clinical, technical, and provider teams by receiving, reviewing, and accurately processing prior authorization (PA) requests for medical and pharmacy services. The role ensures requests are entered and routed efficiently for clinical review, while maintaining compliance with all organizational, state, and federal requirements. The Intake Solutions Specialist provides excellent customer service to providers, internal, and external departments and maintains accuracy and timeliness across all workflows.

In Short

• Receive and process incoming prior authorization requests.
• Verify member eligibility and benefit coverage.
• Confirm services requiring prior authorization.
• Enter authorization requests into the Utilization Management system.
• Review requests for completeness.
• Contact providers for missing details or documentation.
• Monitor and track cases for compliance.
• Maintain confidentiality and ensure HIPAA compliance.
• Assist in reporting and quality improvement activities.
• Support medical and pharmacy authorization workflows.

Requirements

• Associate’s degree or healthcare administration coursework preferred.
• 2–5 years of experience in healthcare or insurance.
• Knowledge of medical terminology and healthcare coding.
• Understanding prior authorization and medical necessity processes.
• Ability to work in a fast-paced environment.
• Excellent verbal and written communication skills.
• Strong customer service and organizational skills.

Benefits

• Impactful work improving healthcare efficiency.
• Remote flexibility with a collaborative team.
• Competitive base compensation and equity options.
• Comprehensive benefits including unlimited PTO.
• Growth opportunities in a fast-paced environment.
• Inclusive culture valuing diverse contributions.