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Intake Care Senior Representative

Careers Integrated Resources Inc
Atlanta, GA Full Time
POSTED ON 4/8/2025
AVAILABLE BEFORE 5/2/2025

Job Title : Intake Care Senior Representative

Location : IL, 100% Remote

Contract : 03 Months (Possibility of Extension)]

Schedule Notes : M-F, Shifts will land between 7 : 30AM-7 : 30PM CST, 8 Hour shifts with 30 min lunch, Training will be the first 4 weeks

Note :

  • This position is 100% remote and candidates can be sourced from across the US as long as they're able to support the CST schedule.
  • Candidates submitted cannot have any time off during the first 5 weeks - do not submit candidates that have pre-planned time off during this timeframe.
  • Candidates must have a quiet and private working environment.

Candidates must have a reliable, high-speed internet connection.

Candidates must have a hard-wired internet connection to connect into the equipment - WiFi connection will not suffice.

Job Description :

The Pre-Certification Specialist is responsible for supporting the Precertification Nurse, Medical Director and Director of Health Services by collecting, interpreting and evaluating medical information received for authorization. The Pre-cert Specialist will communicate with internal and external providers regarding authorization status. This position is for a phone queue representative.

Essential Duties and Responsibilities :

  • Receive request for authorization from hospitals, providers, customers and vendors via fax, phone and portal
  • Meet service level goals (e.g., Grade of Service, Average Handle Time, Average Speed to Answer, abandonment rate)
  • Determine authorization requirements based on company policy, member benefit grid and provider status
  • Review customer coverage and benefits
  • Review authorization requests and make determinations on correct authorization process (i.e. auto approve, refer to Utilization Management Nurse)
  • Maintain benchmark standards for TAT (Turn-Around-Time) as established by the organization.
  • Professional demeanor and the ability to work effectively within a team or independently
  • Flexible with the ability to shift priorities when required
  • Maintains regular and acceptable attendance in accordance with Time Away From Work policy
  • Ability to work evening, weekend and holiday shifts to support the UM Department
  • Other duties as requested
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