Central Admissions / Intake Specialist

Alliance Health & Human Services; Southborough (MA); On-site; USD 90,000 - 100,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical, Dental and Vision Insurance

Matching 401K

Employee Assistance Program

Education assistance or tuition reimb"

Flexible Schedule

Job summary

Alliance Health and Human Services in Southborough, MA seeks a skilled Central Admissions Director to oversee the admissions process for skilled nursing facilities. You will manage referrals, coordinate with hospitals and insurance providers, and ensure compliant placement from referral to admission.

The role emphasizes clinical screening, insurance verification, prior authorization, and accurate end-of-day reporting, with compensation based on experience and a full-time schedule.

Qualifications

• Clinical screening of referrals and medical needs.
• Accurate insurance eligibility and benefits assessment.
• Regulatory compliance oversight during admissions.
• End-to-end admission decisions from referral to placement.

Responsibilities

• Manage and review incoming referrals across hospital platforms and communicate decisions to hospitals and leadership.
• Conduct full clinical screenings including medical history, diagnoses, treatment needs, and level of care appropriateness.
• Maintain ongoing communication with hospital case managers.
• Run full insurance eligibility for Medicare, Medicaid, Managed Care, commercial, and supplemental plans.
• Review benefits, co-pays, SNF coverage days, exclusions, and financial risk factors.
• Identify primary and secondary insurance, out-of-network implications, and authorization requirements.
• Verify all demographic and financial information prior to admission.
• Coordinate with hospital discharge teams and bed availability, isolation needs, dialysis coordination, and transportation arrangements.
• Provide daily recaps of admissions activity and track trends for reporting.

Skills

Clinical screening

Insurance verification

Regulatory compliance

Admission coordination

Data reporting

Referral evaluation

Job description

Alliance Health and Human Services in need of a:

Central Admissions / Intake Specialist

Central Admissions Director / Intake Specialist Alliance Health Management Services Southborough, MA (Corporate Office)

Salary Range: $90,000-$100,000

Position Summary

Alliance Health is expanding its Central Admissions team due to continued growth across our skilled nursing portfolio. We are seeking an experienced Central Admissions Director to join our established team in partnership to oversee the admissions process for our skilled nursing facilities.

This is a high-responsibility role that manages clinical screening, insurance verification, prior authorization, regulatory compliance, and final placement decisions from referral through admission. The position works closely with hospital partners, insurance providers, and internal facility leadership to ensure timely, accurate, and compliant admissions.

Primary Responsibilities Include:

Referral Screening and Clinical Decision-Making

• Manage and review incoming referrals across all hospital referral platforms. Communicate decisions to hospitals, case managers, and internal leadership.
• Conduct full clinical screenings, including medical history, diagnoses, treatment needs, rehabilitation potential, and level of care appropriateness.
• Maintain ongoing communication with hospital case managers.

Insurance Verification and Benefit Determination

• Run full insurance eligibility for all payers, including Medicare, Medicaid, Managed Care, commercial, and supplemental plans.
• Review benefits, co-pays, SNF coverage days, exclusions, and financial risk factors.
• Identify primary and secondary insurance, out-of-network implications, and authorization requirements.
• Verify all demographic and financial information prior to admission.

Coordination with Hospitals and Facilities

• Communicate regularly with hospital case managers, social workers, and discharge teams.
• Coordinate with internal facility teams regarding bed availability, isolation needs, dialysis coordination, transportation arrangements, and specialty equipment requirements.
• Provide consistent updates to administrators and nursing leadership on pending admissions.

End-of-Day Reporting and Data Management

• Provide daily recaps of admissions activity to each facility.
• Track admissions, denials, payer mix, authorization statuses, and referral trends.
• Maintain accurate records for operational, financial, and regulatory reporting.

Benefits offered:

• Paid time off
• Paid holidays
• Medical, Dental and Vision Insurance
• Matching 401K
• Employee Assistance Program
• Education assistance or tuition reimbursement
• Flexible Schedule

Compensation is based on experience!

Job Type: Full-time

Schedule: 40 hours per week

License/Certification: N/A

Work Location: 144 Turnpike Rd, Southborough, MA 01772