Intake and Authorization Specialist

Paycom - ATS; Florida; On-site; USD 42,000 - 56,000; Full time

Job summary

Paycom - ATS in Florida is seeking an Intake & Authorization Specialist to ensure timely and accurate processing of Skilled Home Health referrals. You will verify insurance eligibility, determine prior authorizations, and liaise with physicians, case managers, and insurance payers to prevent delays in patient care.

The role requires 1–2 years in healthcare admissions or home health intake, with preferred Florida home health experience and bilingual English/Spanish abilities.

Qualifications

• High school diploma or equivalent.
• Associate or Bachelor’s degree in Healthcare Administration or related field is a plus.

Responsibilities

• Process referrals: Review incoming Skilled Home Health referrals for completeness.
• Verify insurance eligibility and authorizations, submit requests, and follow up on approvals.
• Identify and resolve missing documentation or discrepancies; escalate complex issues.
• Maintain documentation in CRM/EMR systems (Axxess and Nexus CRM).
• Communicate updates to physicians’ offices, hospital case managers, insurance representatives, and internal clinical team.
• Support HIPAA compliance and assist onboarding/training during peak periods.

Skills

Attention to detail

Multi-tasking

Problem solving

Bilingual English/Spanish

EMR/CRM experience

Education

High school diploma or equivalent

Associate or Bachelor’s degree in Healthcare Administration or related field

Tools

Axxess

Nexus CRM

Job description

About the RoleAre you a detail-oriented healthcare professional with a passion for helping patients access the care they need? We are looking for an Intake & Authorization Specialist to join our Florida team. In this critical role, you will be the bridge between clients, healthcare providers, and insurance payers. You will ensure the timely, accurate, and compassionate handling of Skilled Home Health referrals, laying the foundation for exceptional patient care.What You’ll DoProcess Referrals: Receive and review incoming Skilled Home Health referrals for completeness, ensuring all physician orders, clinical documentation, and patient details are accurate.Insurance Verification & Authorizations: Verify insurance eligibility and benefits. Determine prior authorization needs, submit requests, and aggressively follow up on pending approvals to prevent any delays in patient care.Problem Solve & Escalate: Identify and resolve missing documentation or insurance discrepancies. Proactively escalate complex authorization issues or barriers to timely admission.Data & System Management: Maintain meticulous, compliant documentation of referral status, eligibility, and authorization activities in our CRM and EMR systems (Axxess and Nexus CRM).Collaborative Communication: Act as a key liaison, providing clear, timely updates to physicians' offices, hospital case managers, insurance representatives, and our internal clinical team.Compliance & Support: Maintain strict adherence to HIPAA and regulatory standards. Provide departmental coverage during peak periods and support team onboarding/training as needed.What We Are Looking ForEducation: High school diploma or equivalent required; Associate or Bachelor’s degree in Healthcare Administration or a related field is a plus.Experience: 1–2 years of experience in healthcare admissions, home health intake, medical billing, or insurance authorization. Florida home health experience is strongly preferred.Insurance Savvy: Proven familiarity with Medicare Advantage, commercial insurance, and managed care payer portals.Tech Skills: Experience navigating EMR/CRM systems (experience with Axxess and Nexus CRM is highly desirable).Key Traits: Incredible attention to detail, strong multi-tasking skills in a fast-paced environment, and a proactive approach to solving problems.Languages: Bilingual (English/Spanish) is highly preferred.